Postoperative PRP Injection may Not Enhance ACL Reconstruction Outcomes: Study

Anterior cruciate ligament (ACL) injuries are common in athletes and individuals engaging in physical activities, often requiring surgical intervention for reconstruction. Platelet-rich plasma (PRP) therapy has emerged as a potential adjunctive treatment for musculoskeletal injuries due to its purported ability to enhance tissue healing and regeneration. However, its efficacy in ACL reconstruction outcomes remains uncertain, with conflicting evidence from previous studies.

To compare subjective outcomes and graft maturity in patients undergoing ACL reconstruction with and without postoperative PRP injection. This randomized clinical trial included 120 patients aged 16 to 45 undergoing ACL reconstruction at a national medical center in China. Patients were randomized to receive either postoperative PRP injection (n=60) or no injection (n=60). Follow-up occurred for 12 months. Patients in the PRP group received 3 doses of intra-articular PRP injection at monthly intervals postoperatively, while the control group did not receive PRP injection. Both groups underwent the same rehabilitation protocol and follow-up schedule.

The key findings of the study were:

• Among the 120 participants, 114 were available for primary outcome analysis.

• At 12 months postoperatively, the mean Knee Injury and Osteoarthritis Outcome Score (KOOS4) was 78.3 in the PRP group and 76.8 in the control group, with no statistically significant difference between groups (adjusted mean difference, 2.0; 95% CI, -2.3 to 6.3; P = .36).

• Secondary outcomes, including patient-reported outcomes, graft maturity on magnetic resonance imaging, and physical examinations, did not significantly differ between groups, except for sports and recreation level and graft maturity at 6 months.

• Adverse events associated with PRP injection included pain at the injection site and knee swelling post-injection.

In this randomized clinical trial, the addition of postoperative intra-articular PRP injection did not result in superior improvement of knee symptoms and function at 12 months compared to no injection in patients undergoing ACL reconstruction. These findings suggest that PRP injection may not provide added benefit in the context of ACL reconstruction and highlight the need for further research to determine its appropriate indications and efficacy in musculoskeletal disorders.

Reference:

Ye, Z., Chen, H., Qiao, Y., Wu, C., Cho, E., Wu, X., Li, Z., Wu, J., Lu, S., Xie, G., Dong, S., Xu, J., & Zhao, J. (2024). Intra-articular platelet-rich plasma injection after anterior cruciate ligament reconstruction: A randomized clinical trial. JAMA Network Open, 7(5), e2410134. https://doi.org/10.1001/jamanetworkopen.2024.10134