Platelet rich plasma (PRP) has been shown to be beneficial in anterior cruciate ligament (ACL) reconstruction. The growth factors in PRP such as PDGF, TGF-B, and IGF-1 may help graft maturation. This is important for mechanical strength and return to activity. PRP can also improve ACL function and cell viability as well as accelerate ACL graft healing.
A study done on 100 patients with ACL reconstruction using a tibialis anterior allograft showed less post-operative effusions in the PRP group compared to the control group. At 2 years, there was no difference between groups in patient reported outcomes. There were no reported side effects of using PRP.
There is well-documented decreased morbidity from the bone-patellar tendon-bone donor site. A level one study done on 40 athletes with bone-patellar tendon-bone ACL reconstruction showed significant increases in VISA (function and physical activity) scores in the PRP group versus the control. There were also decreases in VAS score (pain scale) and >70% increase in bone gap filling in PRP group versus 60% in the control group.
Conclusion: there are potential short-term benefits and decreased post-operative effusion rates when using PRP during ACL reconstruction. There is decreased morbidity from the bone-patellar tendon-bone donor site. There is also potentially improved revascularization of ACL graft and/or tunnel.
References:
Cervellin et. al: Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study. Knee Surg Sports Traumatol Arthrosc 2012 20: 114.
Magnussen et. al: Platelet rich plasma use in allograft ACL reconstructions: two-year clinical results of a MOON cohort study. Knee. 2013 Aug;20(4):277-80.
Vavken, et al: The effect of platelet concentrates on graft maturation and graft-bone interface healing in ACL reconstruction in human patients: A systematic review of controlled trials. Arthroscopy. 2011;27(11):1573-1583.
