nach oben

Archives of Orthopaedic and Trauma Surgery

Erschienen in:

01.09.2013 | Arthroscopy and Sports Medicine

Platelet-rich plasma in patients with tibiofemoral cartilage degeneration

verfasst von: Radek Hart, Adel Safi, Martin Komzák, Pavel Jajtner, Miloš Puskeiler, Petra Hartová

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 9/2013

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Recently an articular cartilage repair has been given much attention in the orthopaedic field. Cartilage regeneration capacity is very limited. Optimal approach seems to be a delivery of natural growth factors. Autologous platelet-rich plasma (PRP) contains proliferative and chemoattractant growth factors. The objective of the present study was to determine if PRP can increase tibiofemoral cartilage regeneration and improve knee function.

Materials and methods

Fifty consecutive and strictly selected patients, affected by Grade II or III chondromalatia, underwent 1 year treatment (9 injections) with autologous PRP in a liquid form with 2.0 to 2.5-fold platelets concentration. Outcome measures included the Lysholm, Tegner, IKDC, and Cincinnati scores. Magnetic resonance imaging was used to evaluate cartilage thickness and degree of degeneration.

Results

The study demonstrated significant improvement in Lysholm (p < 0.05), Tegner (p < 0.05), IKDC (p < 0.05), and Cincinnati (p < 0.05) scores. Results improved at 12-month follow-up. Cartilage assessment revealed no significant cartilage regeneration (p < 0.05). There were no adverse events reported.

Conclusions

PRP significantly reduced pain and improved quality of live in patients with low degree of cartilage degeneration. Magnetic resonance imaging did not confirmed any significant cartilage condition improvement.

Frei R, Biosca FE, Handl M, Trč T (2008) The role of growth factors in the human organism and their use in medicine, especially in orthopedics and traumatology. Acta Chir Orthop Traum Cech 75:247–252PubMed

Moor DC, Ehrlich MG, McAllister CC et al (2009) Recombinant human platelet-derived growth factor-BB augmentation of new-bone formation in a rat model of distraction osteogenesis. J Bone Jt Surg Am 91:1973–1984CrossRef

Akeda K, An HS, Okuma M et al (2006) Platelet-rich plasma stimulates porcine articular chondrocytes proliferation and matrix biosynthesis. Osteoarthr Cartil 14:1272–1280PubMedCrossRef

Mishra A, Tummala P, King A et al (2009) Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods 15:431–435PubMedCrossRef

Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves Achilles tendon repair. Acta Orthop Scand 75:93–99PubMedCrossRef

Filardo G, Kon E, Della Vill S, Vincentelli F, Fornasari PM, Marcacci M (2010) Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop 34:909–915PubMedCrossRef

Fallouh L, Nakagawa K, Sasho T et al (2010) Effects of autologous platelet-rich plasma on cell viability and collagen synthesis in injured human anterior cruciate ligament. J Bone Jt Surg Am 92:2909–2916CrossRef

Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Jt Surg Br 43:752–767

Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sport Med 10:150–154CrossRef

10.

Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligaments injuries. Clin Orthop 198:43–49PubMed

11.

Hefti F, Drobny T, Hackenbush W et al (1990) Evaluation of knee ligament injuries: the OAK and IKDC forms. In: Jakob RP, Staubli HU (eds) The knee and the cruciate ligament. Sprinter, Berlin, pp 134–139

12.

Notes FR, Barber SD, Mooar LA (1989) A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop 246:238–249

13.

Sun Y, Feng Y, Zhang CQ, Chen SB, Cheng XG (2010) The regenerative effect of platelet-rich plasma on healing in large osteochondral defects. Int Orthop 34:589–597PubMedCrossRef

14.

Saito M, Takahashi KA, Arai Y et al (2009) Intraarticular administration of platelet-rich plasma with biodegradable gelatin hydrogel microspheres prevents osteoarthritis progression in the rabbit knee. Clin Exp Rheumatol 27:201–207PubMed

15.

Qi YY, Chen X, Jiang YZ et al (2009) Local delivery of autologous platelet in collagen matrix stimulated in situ articular cartilage repair. Cell Transpl 18:1161–1169CrossRef

16.

Kon E, Filardo G, Delcogliano M et al (2010) Platelet autologous growth factors decrease the osteochondral regeneration capability of a collagen-hydroxyapatite scaffold in a sheep model. BMC Musculoskelet Disord 11:220–223PubMedCrossRef

17.

Anitua E, Sánchez M, Zalduendo MM et al (2009) Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif 42:162–170PubMedCrossRef

18.

Graziani F, Ivanovski S, Cei S, Ducci F, Tonetti M, Gabriele M (2006) The in vitro effect of different PRP concentrations on osteoblasts and fibroblasts. Clin Oral Implant Res 17:212–219CrossRef

19.

Bramono DS, Richmond JC, Weitzel PP, Kaplan DL, Altman GH (2002) Matrix metalloproteinases and their clinical applications in orthopaedics. Clin Orthop Relat Res 428:272–285CrossRef

20.

Anitua E, Sánchez M, Nurden AT et al (2007) Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritis patients. Rheumatology 46:1769–1772PubMedCrossRef

21.

Kon E, Buda R, Filardo G et al (2010) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18:472–479PubMedCrossRef

22.

Filardo G, Kon E, Buda R et al (2011) Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc 19:528–535PubMedCrossRef

23.

Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B (2010) Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study. Am J Phys Med Rehabil 89:961–969PubMedCrossRef

24.

Pihlajamäki HK, Kuikka P-I, Leppänen V-V, Kiuru MJ, Mattila VM (2010) Reliability of clinical findings and magnetic resonance imaging for the diagnosis of chondromalacia patellae. J Bone Jt Surg Am 92:927–934CrossRef

Titel: Platelet-rich plasma in patients with tibiofemoral cartilage degeneration
verfasst von: Radek Hart
Adel Safi
Martin Komzák
Pavel Jajtner
Miloš Puskeiler
Petra Hartová
Publikationsdatum: 01.09.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 9/2013
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-013-1782-x

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

25.04.2024 | Hypertonie | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Platelet-rich plasma in patients with tibiofemoral cartilage degeneration

Abstract

Introduction

Materials and methods

Results

Conclusions

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie

Springer Medizin

Abstract

Introduction

Materials and methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2013

Median neuropathy in malunited fractures of the distal radius

Autologous double-barrel vascularized fibula bone graft for arthrodesis of the shoulder after tumor resection

The use of posterior vertebral column resection in the management of severe posttuberculous kyphosis: a retrospective study and literature review

Preoperative predictors for allogenic blood transfusion in hip and knee arthroplasty for rheumatoid arthritis

Evidence of an autoregulatory mechanism of regional bone blood flow at hypotension

Clinical and biomechanical investigation of an increased articular cavity depth after distal radius fractures: effect on range of motion, osteoarthrosis and loading patterns

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Update Orthopädie und Unfallchirurgie