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Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2015, vol. 21, issue 3
Subject Area: Medicine - Orthopedics and Traumatology
Pages: 814-817
DOI: 10.5272/jimab.2015213.814
Published online: 22 July 2015
J of IMAB 2015 Jul-Sep;21(3):814-817
PLATELET RICH PLASMA (PRP) APPLICATION IN TOTAL KNEE ARTHROPLASTY (TKA).
Pencho Kosev
, Tsvetan Sokolov, Ivalinka Pavlova, Boyan Valentinov, Jordan Andonov, Neli Petrova.
Department of Orthopedics and Traumatology, MHAT Ruse, Ruse, Bulgaria.
ABSTRACT:
PURPOSE: To find out the PRP application effects in TKA on pain syndrome, wound healing, postoperative blood loss, range of motion and the knee circumference (centimetry).
MATERIAL AND METHOD: The preparation of the platelet-rich plasma is based on our treatment algorithm. 20 patients have been subject to TKA within the period from October 2012 to November 2014 and underwent TKA, as platelet rich plasma was used intraoperatively. The average patient age is 72,3; 9 male and 11 female patients. Control group consisted of 17 patients, who underwent surgery in the same period but no platelet rich plasma was used during surgery. Average patient age 73,1; 8 male and 9 female patients.
RESULTS: The following results have been reported for the PRP group of patients: the average amount of blood in the aspiration drainage tube in 24 hours - 285 ml.; postoperative pain on the 1st postoperative day was - 7 p., on the 5th day - 5 p., on the 10th day - 2 p., average circumference (centimetry) of the knee between the 1st and the 10th postoperative day decreased on average by 1,5-2 cm., range of motion – reported average degrees per patient on the 1st postoperative day in sagittal plane: 0-10-20 degrees; on the 10th postoperative day: 0-0-55 degrees, surgical wounds of all patients healed primarily without any complications. No PRP group: average amount of blood in the aspiration drainage in 24 hours – 300 pl., postoperative pain on the 1st, 5th , and 10th postoperative day - 8 p., on the 5th day - 6 p., on the 10th day - 3 p., average knee circumference (centimetry) between 1 and 10 postoperative day has decreased by 1 cm on average, range of motion - reported average degrees per patient on the 1st postoperative day in sagittal plane 0-5-20 degrees, on the 10th: 0-0-50 degrees, surgical wounds healed primarily without any complications in 10 patients, but in 7 patients we observed superficial wound edge skin necrosis.
CONCLUSION: Our results unequivocally show that platelet-rich plasma reduces postoperative blood loss and the use of narcotics, improves the range of motion and the circumference of the operated joint and it is crucial for the most common postoperative complications of TKA: namely dermal wound problems.
Key words: platelet rich plasma, range of motion, total knee arthroplasty, wound healing,
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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Kosev P, Sokolov T, Pavlova I, Valentinov B, Andonov J, Petrova N. Platelet rich plasma (PRP) application in total knee arthroplasty (TKA). J of IMAB. 2015 Jul-Sep;21(3):814-817. doi: http://dx.doi.org/10.5272/jimab.2015213.814
Correspondence to: Assoc. Prof. Pencho Kosev, MD, PhD, Department of Orthopedics and Traumatology, MHAT Ruse, Ruse, Bulgaria; 2, Nezavisimost str., 7002 Ruse, Bulgaria; E-mail: kosev_pencho@yahoo.com
REFERENCES:
1. Horstmann WG, Slappendel R, van Hellemondt GG, WymengaAW, Jack N, Everts PA. Autologous platelet gel in total knee arthroplasty: a prospective randomized study. Knee SurgSports Traumatol Arthrosc. 2011 Jan;19(1):115–21. [PubMed] [CrossRef]
2. Gardner MJ, Demetrakopoulos D, Klepchick PR, Mooar PA. The efficacy of autologous platelet gel in pain control and bloodloss in total knee arthroplasty. An analysis of the haemoglobin, narcotic requirement and range of motion. Int Orthop. 2007 Jun;31(3):309–13. [PubMed] [CrossRef]
3. Hollowell J, Grocott MP, Hardy R, Haddad FS, Mythen MG, Raine R. Major elective joint replacement surgery: socioeconomic variations in surgical risk, postoperative morbidity and length of stay . J Eval Clin Pract. 2010 Jun;16(3):529–38. [PubMed] [CrossRef]
4. Van Herck P, Vanhaecht K, Deneckere S, Bellemans J, Panella M, Barbieri A, Sermeus W. Key interventions and outcomes in joint arthroplasty clinical pathways: a systematic review. J Eval Clin Pract. 2010 Feb;16(1):39–49. [PubMed] [CrossRef]
5. Prasad N, Padmanabhan V, Mullaji A. Blood loss with total knee arthroplasty.Int.Orthop.2007 Feb;31(1):39-44. [PubMed] [CrossRef]
6. Bosco JA 3rd, Slover JD, Haas JP. Perioperative strategies for decreasing infection: a comprehensive evidence-based approach. J Bone Joint Surg Am. 2010 Jan;92(1):232-9. [PubMed]
7. Everts PA, Devilee RJ, Brown Mahoney C, Eeftinck-Schattenkerk M, Box HA, Knape JT, et al. Platelet geland fibrin sealant reduce allogeneic blood transfusions intotal knee arthroplasty. Acta Anaesthesiol Scand. 2006 May;50(5):593–9. [PubMed] [CrossRef]
8. Kawamura M, Sawafuji M, Watanabe M, Horinouchi H, Kobayashi K. Frequency of transmission of human parvovirus B19 infection by fibrin sealant used during thoracic surgery. Ann Thorac Surg. 2002 Apr;73(4):1098-100. [PubMed]
9. Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports Med. 2009 May;39(5):345-54. [PubMed] [CrossRef]
10. Berghoff WJ, Pietrzak WS, Rhodes RD. Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics. 2006 Jul;29(7):590-8. [PubMed]
11. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S240-52. [PubMed] [CrossRef]
12. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-richplasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009 Mar;27(3):158-67. [PubMed] [CrossRef]
13. Carter MJ, Fylling CP, Parnell LK. Use of platelet-rich plasma gel on wound healing: a systematic review and meta-analysis. Eplasty. 2011; 11:e38. [PubMed]
14. Cancela AM, Lana JF, Annichino-Bizzachi JM, Belangero WD, Luzo AC. Use of Platelet-Rich Plasma (PRP) in Treating Chronic Wounds. In: Lana JF, et al. (eds.), Platelet-Rich Plasma. Lecture Notes in Bioengineering. Springer-Verlag Berlin, Heidelberg. 2014; p281-288. [CrossRef]
15. Peerbooms JC, de Wolf GS, Colaris JW, Bruijn DJ, Verhaar JA. No positive effect of autologous platelet gel after total kneearthroplasty. Acta Orthop. 2009 Oct;80(5):557-62. [PubMed] [CrossRef]
16. Guerreiroa JP, Danieli MV, Queiroza AO, Deffuneb E, Ferreira RR. Platelet-rich plasma (PRP) applied during total kneearthroplasty. Rev Bras Ortop (English Edition). 2015 Mar-Apr;50(2):186-194. [CrossRef].
Received: 07 April 2015
Published online: 22 July 2015