Skip to main content
Erschienen in: International Orthopaedics 5/2016

09.07.2015 | Original Paper

The role of platelet rich plasma in management of fracture neck femur: new insights

verfasst von: Ahmed Mohamed Samy

Erschienen in: International Orthopaedics | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study is evaluation of the efficacy of the use of platelet rich plasma (PRP) in management of femoral neck fractures.

Materials and methods

This is a prospective study that was conducted between February 2010 and March 2013. A total of 60 patients were included in this study, categorized randomly into two groups. Group A included fracture neck femur treated by closed reduction and internal fixation with three cannulated screws and group B by addition of PRP to internal fixation. We planned to compare time of healing, need for revision and incidence of complications between the two groups.

Results

Union occurred in 53 patients (88.33 %) in both groups, 25 cases (83.3 %) in group A and 28 cases (93.3 %) in group B, including three cases (5 %) with avascular necrosis (AVN): two in group A (6.7 %) and one case in group B (3.3 %).Revision surgery was done for six cases (20 %) in group A and for two cases (6.7 %) in group B. In both groups, all united cases had good to excellent clinical outcome as regards Harris hip score (HHS) at the end of the follow up.

Conclusion

Despite advances in surgical techniques and medical care, the risk of nonunion and avascular necrosis (AVN) after treatment of femoral neck fractures have not been changed appreciably in the last 50 years. Results of this study generally showed that both the median clinical and radiographic healing time were lower in group B compared to group A.
Literatur
1.
Zurück zum Zitat Whitman DH, Berry RL, Green DM (1997) Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. J Oral Maxillofac Surg 55(11):1294–1299CrossRefPubMed Whitman DH, Berry RL, Green DM (1997) Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. J Oral Maxillofac Surg 55(11):1294–1299CrossRefPubMed
2.
Zurück zum Zitat Peerbooms JC, Colaris JW, Gosens T et al (2012) No positive bone healing after using platelet rich plasma in a skeletal defect. An observational prospective cohort study. Int Orthop 36(10):2113–2119CrossRefPubMedPubMedCentral Peerbooms JC, Colaris JW, Gosens T et al (2012) No positive bone healing after using platelet rich plasma in a skeletal defect. An observational prospective cohort study. Int Orthop 36(10):2113–2119CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Lu-Yao GL, Keller RB, Littenberg B et al (1994) Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am 76:15–25PubMed Lu-Yao GL, Keller RB, Littenberg B et al (1994) Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am 76:15–25PubMed
4.
Zurück zum Zitat Garden RS (1961) Low-angle fixation in fractures of the femoral neck. JBJS 43:647–663 Garden RS (1961) Low-angle fixation in fractures of the femoral neck. JBJS 43:647–663
5.
Zurück zum Zitat Filardo G, Kon E, Ruiz MTP et al (2012) Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc 20:2082–2091CrossRefPubMed Filardo G, Kon E, Ruiz MTP et al (2012) Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc 20:2082–2091CrossRefPubMed
6.
Zurück zum Zitat Warden V, Hurley AC, Volicer L (2003) Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc 4:9–15CrossRefPubMed Warden V, Hurley AC, Volicer L (2003) Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc 4:9–15CrossRefPubMed
7.
Zurück zum Zitat Yoo MC, Chung DW, Hahn CS (1992) Free vascularized fibula grafting for the treatment of osteonecrosis of the femoral head. Clin Orthop Relat Res 277:128–138PubMed Yoo MC, Chung DW, Hahn CS (1992) Free vascularized fibula grafting for the treatment of osteonecrosis of the femoral head. Clin Orthop Relat Res 277:128–138PubMed
8.
Zurück zum Zitat Parker MJ, Raghavan R, Gurusamy K (2007) Incidence of fracture-healing complications after femoral neck fractures. Clin Orthop Relat Res 458:175–179PubMed Parker MJ, Raghavan R, Gurusamy K (2007) Incidence of fracture-healing complications after femoral neck fractures. Clin Orthop Relat Res 458:175–179PubMed
9.
Zurück zum Zitat Stravrakis TA, Lyras DN, Psillakis IG (2009) Fractures of the femoral neck treated with hemi arthroplasty. Folia Med 51:134–145 Stravrakis TA, Lyras DN, Psillakis IG (2009) Fractures of the femoral neck treated with hemi arthroplasty. Folia Med 51:134–145
10.
Zurück zum Zitat Wong RW, Rabie AB (2003) Statin collagen grafts used to repair defects in the parietal bone of rabbits. Br J Oral Maxillofac Surg 41:244–248CrossRefPubMed Wong RW, Rabie AB (2003) Statin collagen grafts used to repair defects in the parietal bone of rabbits. Br J Oral Maxillofac Surg 41:244–248CrossRefPubMed
11.
Zurück zum Zitat Haidukewych GJ, Rothwell WS, Jacofsky DJ (2004) Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. JBJS (Am) 86:1711–1716 Haidukewych GJ, Rothwell WS, Jacofsky DJ (2004) Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. JBJS (Am) 86:1711–1716
12.
Zurück zum Zitat Leighton R (2008) Classification and treatment and treatment of femoral neck nonunions in young patients. J Bone Joint Surg Br 90:124–128 Leighton R (2008) Classification and treatment and treatment of femoral neck nonunions in young patients. J Bone Joint Surg Br 90:124–128
13.
Zurück zum Zitat Shih CH, Wang KC (1991) Femoral neck fractures. 121 cases treated by Knowles pinning. Clin Orthop Relat Res 271:195–200PubMed Shih CH, Wang KC (1991) Femoral neck fractures. 121 cases treated by Knowles pinning. Clin Orthop Relat Res 271:195–200PubMed
14.
Zurück zum Zitat Rodríguez-Merchán EC (2002) In situ fixation of nondisplaced intracapsular fractures of the proximal femur. Clin Orthop Relat Res 399:42–51CrossRefPubMed Rodríguez-Merchán EC (2002) In situ fixation of nondisplaced intracapsular fractures of the proximal femur. Clin Orthop Relat Res 399:42–51CrossRefPubMed
15.
Zurück zum Zitat Ort PJ, LaMont J (1984) Treatment of femoral neck fractures with a sliding compression screw and two Knowles pins. Clin Orthop Relat Res 190:158–162PubMed Ort PJ, LaMont J (1984) Treatment of femoral neck fractures with a sliding compression screw and two Knowles pins. Clin Orthop Relat Res 190:158–162PubMed
16.
Zurück zum Zitat Altan E, Aydin K, Ugras S et al (2014) The effect of platelet-rich plasma on osteochondral defects treated with mosaicplastynt. Orthopedics 38(6):1321–1328CrossRef Altan E, Aydin K, Ugras S et al (2014) The effect of platelet-rich plasma on osteochondral defects treated with mosaicplastynt. Orthopedics 38(6):1321–1328CrossRef
17.
Zurück zum Zitat Gerber C, Strehle J, Ganz R (1993) The treatment of the fractures of the femoral neck. Clin Orthop 292:77–86PubMed Gerber C, Strehle J, Ganz R (1993) The treatment of the fractures of the femoral neck. Clin Orthop 292:77–86PubMed
18.
Zurück zum Zitat Cserhati P, Kazar G, Manninger J et al (1996) Non-operative or operative treatment for undisplaced femoral neck fractures: a comparative study of 122 non-operative and 125 operatively treated cases. Injury 27:583–588CrossRefPubMed Cserhati P, Kazar G, Manninger J et al (1996) Non-operative or operative treatment for undisplaced femoral neck fractures: a comparative study of 122 non-operative and 125 operatively treated cases. Injury 27:583–588CrossRefPubMed
19.
Zurück zum Zitat Swiontkowski MF (1994) Current concept review: intracapsuler fractures of the hip. JBJS 76A:129–138 Swiontkowski MF (1994) Current concept review: intracapsuler fractures of the hip. JBJS 76A:129–138
20.
Zurück zum Zitat Barnes R, Brown JT, Garden RS, Nicoll EA (1976) Subcapital fractures of the femur. A prospective review. J Bone Joint Surg Br 58:2–24PubMed Barnes R, Brown JT, Garden RS, Nicoll EA (1976) Subcapital fractures of the femur. A prospective review. J Bone Joint Surg Br 58:2–24PubMed
21.
Zurück zum Zitat Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH (1995) Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am 77:1551–1556PubMed Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH (1995) Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am 77:1551–1556PubMed
22.
Zurück zum Zitat Aggarwal AK, Shashikanth VS, Marwaha N (2014) Platelet-rich plasma prevents blood loss and pain and enhances early functional outcome after total knee arthroplasty: a prospective randomised controlled study. Int Orthop 38(2):387–395CrossRefPubMedPubMedCentral Aggarwal AK, Shashikanth VS, Marwaha N (2014) Platelet-rich plasma prevents blood loss and pain and enhances early functional outcome after total knee arthroplasty: a prospective randomised controlled study. Int Orthop 38(2):387–395CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Peerbooms JC, Wolf GS, Colaris JW, Bruijn DJ, Verhaar JA (2009) No positive effect of autologous platelet gel after total knee arthroplasty. Acta Orthop 80:557–562CrossRefPubMedPubMedCentral Peerbooms JC, Wolf GS, Colaris JW, Bruijn DJ, Verhaar JA (2009) No positive effect of autologous platelet gel after total knee arthroplasty. Acta Orthop 80:557–562CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Berghoff W, Pietrzak W, Rhodes R (2006) Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics 29(7):590–598PubMed Berghoff W, Pietrzak W, Rhodes R (2006) Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics 29(7):590–598PubMed
Metadaten
Titel
The role of platelet rich plasma in management of fracture neck femur: new insights
verfasst von
Ahmed Mohamed Samy
Publikationsdatum
09.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 5/2016
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2844-1

Weitere Artikel der Ausgabe 5/2016

International Orthopaedics 5/2016 Zur Ausgabe

Arthropedia

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

Update Orthopädie und Unfallchirurgie

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