Purpose
To perform a systematic review of the randomized controlled trials (RCTs) evaluating
the efficacy of platelet-rich plasma (PRP) to augment anterior cruciate ligament (ACL)
reconstruction.
Methods
Two independent reviewers screened the MEDLINE, The Cochrane Library, and EMBASE databases
using Preferred Reporting for Systematic Reviews and Meta-Analyses guidelines for
applicable RCTs evaluating the efficacy of PRP in ACL reconstruction. A meta-analysis
was performed on the papers involving bone–patellar tendon–bone (BPTB) grafting.
Results
Thirteen RCTs fulfilled the inclusion criteria involving 765 patients. There was no
clinical improvement (Tegner, Lysholm, Knee Injury and Osteoarthritis Outcome Score,
or International Knee Documentation Committee scores) in any of the 7 studies evaluating
PRP alongside the hamstring tendon autograft ACL reconstructions versus the control.
Two studies evaluating PRP for hamstring tendon autograft demonstrated significantly
improved magnetic resonance imaging findings. Two studies analyzed the use of PRP
with allograft ACL reconstruction showed no clinical, biochemical, or radiologic improvements
in postoperative follow-up. No functional improvements were found when PRP was used
alongside BPTB in 4 studies. There was no significant difference in visual analog
scale score in the BPTB group (1.1 vs 1.5, P = .18), or tibial filling defects (P = .30).
Conclusions
This study found that the current level I evidence does not support the use of PRP
to improve graft healing, improve donor-site morbidity, reduce postoperative pain
levels, or improve functional outcomes following ACL reconstruction.
Level of Evidence
Level I; systematic review of level I evidence
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Article info
Publication history
Published online: January 24, 2020
Accepted:
November 4,
2019
Received:
June 19,
2019
See commentary on page 1211Footnotes
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
