Uso de PRP en Sutura Meniscal
Keywords:
PRP, Meniscus, Meniscal Repair, Plasma, PlateletAbstract
Platelet Rich Plasma (PRP) has been used in different aspects of orthopedics, including muscle, bone, tendons and ligament surgery. PRP might accelerate or improve the healing process, allowing an earlier return to sports activities. PRP is obtained from autologous blood, which is centrifuged, obtaining platelets and growth factor concentrations higher than those of regular blood.
Meniscal repair with the use of PRP has not attracted the same amount of investigation compared to ligamentous surgery. Currently, there are few published studies available regarding the effect of PRP on meniscal repair outcomes, and most of them are underpowered to assess repair failure as a primary outcome measure.
With the actual evidence we cannot recommend for the use of PRP in every meniscal repair, but encouraging evidence is being published supporting its use in patients with higher risk of failure (isolated repairs, extended indications).
Downloads
References
Figueroa P D, Figueroa B F, Ahumada P X, Calvo R R, Vaisman B A. Uso del plasma rico en plaquetas en cirugía ligamentosa de rodilla [Use of platelet rich plasma in knee ligament surgery]. Rev Med Chil. 2013;141(10):1315–1320. doi:10.4067/S0034-98872013001000011
Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost. 2004;91(1):4–15. doi:10.1160/TH03-07-0440
Ikeuchi H. Trial and error in the development of instruments for endoscopic knee surgery. Orthop Clin North Am. 1982;13(2):263–276.
Greis PE, Holmstrom MC, Bardana DD, Burks RT. Meniscal injury: II. Management. J Am Acad Orthop Surg. 2002;10(3):177–187. doi:10.5435/00124635-200205000-00004
Laible C, Stein DA, Kiridly DN. Meniscal repair. J Am Acad Orthop Surg. 2013;21(4):204–213. doi:10.5435/JAAOS-21-04-204
Nepple JJ, Dunn WR, Wright RW. Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. J Bone Joint Surg Am. 2012;94(24):2222–2227. doi:10.2106/JBJS.K.01584
Yeo DYT, Suhaimi F, Parker DA. Factors Predicting Failure Rates and Patient-Reported Outcome Measures After Arthroscopic Meniscal Repair. Arthroscopy. 2019;35(11):3146–3164.e2. doi:10.1016/j.arthro.2019.06.016
Kaminski R, Kulinski K, Kozar-Kaminska K, et al. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating Meniscal Healing, Clinical Outcomes, and Safety in Patients Undergoing Meniscal Repair of Unstable, Complete Vertical Meniscal Tears (Bucket Handle) Augmented with Platelet-Rich Plasma. Biomed Res Int. 2018;2018:9315815. Published 2018 Mar 11. doi:10.1155/2018/9315815
Kaminski R, Maksymowicz-Wleklik M, Kulinski K, Kozar-Kaminska K, Dabrowska-Thing A, Pomianowski S. Short-Term Outcomes of Percutaneous Trephination with a Platelet Rich Plasma Intrameniscal Injection for the Repair of Degenerative Meniscal Lesions. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study. Int J Mol Sci. 2019;20(4):856. Published 2019 Feb 16. doi:10.3390/ijms20040856
Griffin JW, Hadeed MM, Werner BC, Diduch DR, Carson EW, Miller MD. Platelet-rich plasma in meniscal repair: does augmentation improve surgical outcomes?. Clin Orthop Relat Res. 2015;473(5):1665–1672. doi:10.1007/s11999-015-4170-8
Pujol N, Salle De Chou E, Boisrenoult P, Beaufils P. Platelet-rich plasma for open meniscal repair in young patients: any benefit?. Knee Surg Sports Traumatol Arthrosc. 2015;23(1):51–58. doi:10.1007/s00167-014-3417-3
Kemmochi M, Sasaki S, Takahashi M, Nishimura T, Aizawa C, Kikuchi J. The use of platelet-rich fibrin with platelet-rich plasma support meniscal repair surgery. J Orthop. 2018;15(2):711–720. Published 2018 May 15. doi:10.1016/j.jor.2018.05.006
Dai WL, Zhang H, Lin ZM, Shi ZJ, Wang J. Efficacy of platelet-rich plasma in arthroscopic repair for discoid lateral meniscus tears. BMC Musculoskelet Disord. 2019;20(1):113. Published 2019 Mar 18. doi:10.1186/s12891-019-2500-9
Everhart JS, Cavendish PA, Eikenberry A, Magnussen RA, Kaeding CC, Flanigan DC. Platelet-Rich Plasma Reduces Failure Risk for Isolated Meniscal Repairs but Provides No Benefit for Meniscal Repairs With Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2019;47(8):1789–1796. doi:10.1177/0363546519852616
Figueroa D, Figueroa F, Calvo R, Vaisman A, Ahumada X, Arellano S. Platelet-rich plasma use in anterior cruciate ligament surgery: systematic review of the literature. Arthroscopy. 2015;31(5):981–988. doi:10.1016/j.arthro.2014.11.022
Figueroa D, Melean P, Calvo R, et al. Magnetic resonance imaging evaluation of the integration and maturation of semitendinosus-gracilis graft in anterior cruciate ligament reconstruction using autologous platelet concentrate. Arthroscopy. 2010;26(10):1318–1325. doi:10.1016/j.arthro.2010.02.010
Vance K, Meredick R, Schweitzer ME, Lubowitz JH. Magnetic resonance imaging of the postoperative meniscus. Arthroscopy. 2009;25(5):522–530. doi:10.1016/j.arthro.2008.08.013
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Francisco Figueroa
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This work is published under a Creative Commons Attribution–NonCommercial–ShareAlike 4.0 International License (CC BY-NC-SA 4.0). The authors retain the copyright.
