Background:Arthroscopic meniscectomy is one of the most performed surgical procedures in orthopaedics. Different approaches have been proposed to improve patient recovery but with unsatisfactory results. Platelet-rich plasma (PRP) augmentation has been proposed as a strategy to improve the recovery after meniscectomy.Purpose:To investigate the clinical benefits of an intra-articular PRP injection after meniscectomy, in terms of faster and better patient recovery.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:Ninety patients were randomized into a treatment group, with arthroscopic partial meniscectomy immediately followed by a 5-mL injection of autologous conditioned plasma, and a control group with partial meniscectomy alone. Patients were evaluated at baseline and at 15, 30, 60, and 180 days of follow-up with the visual analog scale (VAS) score for pain (primary outcome), as well as with International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score subscales, Tegner score, and EuroQol-Visual Analog Scale score. Objective evaluation was performed analyzing knee range of motion and circumference and the International Knee Documentation Committee objective score. Complications, patient judgment, and satisfaction were documented as well.Results:No major complications and an overall significant improvement in the clinical scores were observed in both groups. Overall, the comparative analysis did not demonstrate significant between-group differences in absolute values or improvements of both subjective and objective scores, as well as activity level. The improvement in terms of VAS pain score for the treatment group was significant already at 15 days (from 4.3 ± 2.5 to 2.5 ± 2.5; P = .014), while in the control group it became significant at 30 days (from 3.7 ± 2.3 to 2.0 ± 2.4; P = .004). No significant differences were observed between the 2 groups in terms of judgment of treatment results and satisfaction.Conclusion:A single postoperative injection of PRP was not able to significantly improve patient recovery after arthroscopic partial meniscectomy. PRP augmentation did not provide overall benefits at a short-term follow-up (6 months) in terms of pain relief, function, objective parameters, and return-to-sport activities.Registration:NCT02872753 (ClinicalTrials.gov identifier).

中文翻译：

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富含血小板的血浆注射不能改善关节镜下半月板部分切除术后的恢复：一项双盲随机对照试验


背景： 关节镜下半月板切除术是骨科中最常用的外科手术之一。已经提出了不同的方法来改善患者康复，但结果并不令人满意。富血小板血浆 （PRP） 增强已被提议作为改善半月板切除术后恢复的策略。目的： 探讨半月板切除术后关节内注射 PRP 在患者更快、更好地恢复方面的临床益处。研究设计： 随机对照试验;证据水平： 90 例患者被随机分为治疗组，关节镜下半月板部分切除术后立即注射 5 mL 自体条件血浆，对照组单独进行半月板部分切除术。在基线和随访 15 、 30 、 60 和 180 天时，使用视觉模拟量表 （VAS） 评分 （主要结果） 以及国际膝关节文献委员会主观评分、膝关节损伤和骨关节炎结果评分分量表、Tegner 评分和 EuroQol-视觉模拟量表评分。进行客观评估，分析膝关节活动度和周长以及国际膝关节文献委员会客观评分。并发症、患者判断和满意度也被记录在案。结果： 两组均未观察到主要并发症，临床评分总体显著改善。总体而言，比较分析未显示绝对值存在显著组间差异或主观和客观评分以及活动水平的改善。治疗组在 15 天时 VAS 疼痛评分的改善已经显着 （从 4.3 ± 2.5 提高到 2.5 ± 2.5;P = .014），而在对照组中，它在 30 天时变得显着 （从 3.7 ± 2.3 到 2.0 ± 2.4;P = .004）。两组在治疗结果和满意度的判断方面未观察到显著差异。结论： 术后单次注射 PRP 不能显著改善关节镜下半月板部分切除术后患者的恢复。在短期随访 （6 个月） 中，PRP 增强在疼痛缓解、功能、目标参数和恢复运动活动方面没有提供总体益处。Registration：NCT02872753 （ClinicalTrials.gov 标识符）。