PRP has no significant effect on tendon-bone healing after ACL reconstruction

Heng Gong et al found in a prospective randomized controlled study that PRP had no significant effect on reducing bone tunnel widening, accelerating tendon-bone healing, or improving knee function; however, PRP may improve intra-articular graft (IAG) maturation.

60 patients with ruptured ACLs were divided one-to-one into two groups (study and control). Patients were treated using single-bundle autologous hamstring autografts. Only patients in the study group were administered PRP. Knee function (pre-operative and three-, six-, and 12-month post-operative Lysholm activity, Tegner and International Knee Documentation Committee scores, femoral tunnel (FT) and tibial tunnel (TT) diameters measured with computed tomography (post-operative follow-up at 4 days and at 12 months), and magnetic resonance imaging signal/noise quotients of the IAG and graft in the FT (at 12 months) were used to evaluate tendon–bone healing and graft maturation.

Before each patient's operation, 36 ml of peripheral blood was drawn from the patient's median cubital vein with 4 ml anticoagulant citrate dextrose solution A in a 50ml syringe. After fully mixing its contents, the barrel of the syringe was placed into a special centrifugal tube from the kit and performed the first centrifugation. Afterwards, the lower layer was removed, which comprised red blood cells, and performed centrifugation again on the upper layer, which comprised plasma. Finally, the platelet-poor top layer of plasma was discarded, and approximately 4 ml of PRP remained.