Clinical efficacy of injectable autologous platelet preparations in patients after arthroscopic repair of the anterior cruciate ligament

Background. Platelet-rich plasma (PRP) can be used in the treatment of knee joint defects, including relief of complications in the early postoperative period after arthroscopic repair of the anterior cruciate ligament. Low-pulse laser radiation (LPLR) with wavelength 635 nm stimulates the platelet activity in PRP and increases their realization of reparative potential.

Objective. To evaluate the clinical effect of injectable autologous platelet preparations in patients in the early postoperative period after arthroscopic repair of the anterior cruciate ligament.

Material and methods. The study included 45 patients, who underwent arthroscopic prosthetics of the anterior cruciate ligament or its fixation to the place of attachment. The patients were divided into 3 groups: in the 1st group (15 people) the operation was performed without using platelet preparations (the comparison group); in the 2nd group (15 people), non-activated autologous PRP was intraoperatively administered; in the 3rd group (15 people), LPLR-activated autologous PRP was intraoperatively administered. The PRP was exposed to LPLR with wavelength 635 nm and power 2 W for 10 minutes. Two ml of the autologous platelet-rich preparation were injected intra-articularly; additionally 1 ml of the same preparation was applied in a fan-like pattern to the surrounding soft tissues.

Results. After surgery patients in comparison group had moderate acute pain syndrome, while patients in main groups did not complain about severe pain in the area of surgery. The use of autologous PRP-preparations significantly reduced pain assessments by Visual Analogue Scale by 1.5 times in the 2nd group and 3 times in the 3rd group, comparing to patients without PRP treatment (p<0.001). The administration of analgesics was required in 14 patients of the 1st group, 4 patients of the 2nd group, and 2 patients of the 3rd group. The formation of edema and intra-articular hematoma at surgical site in the 2nd and 3rd groups was less pronounced than in the 1st group.

Conclusions. Intra- and periarticular administration of non-activated and LPLR-activated PRP allowed to reduce pain and the incidence of hemarthrosis after knee surgery. The use of LPLR-activated PRP demonstrates more pronounced anti-inflammatory and hemostatic effects comparing to non-activated PRP.

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