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Int J Mol Sci ; 20(4)2019 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-30781461

RESUMO

Meniscal tears are the most common orthopaedic injuries, with chronic lesions comprising up to 56% of cases. In these situations, no benefit with surgical treatment is observed. Thus, the purpose of this study was to investigate the effectiveness and safety of percutaneous intrameniscal platelet rich plasma (PRP) application to complement repair of a chronic meniscal lesion. This single centre, prospective, randomized, double-blind, placebo-controlled study included 72 patients. All subjects underwent meniscal trephination with or without concomitant PRP injection. Meniscal non-union observed in magnetic resonance arthrography or arthroscopy were considered as failures. Patient related outcome measures (PROMs) were assessed. The failure rate was significantly higher in the control group than in the PRP augmented group (70% vs. 48%, P = 0.04). Kaplan-Meyer analysis for arthroscopy-free survival showed significant reduction in the number of performed arthroscopies in the PRP augmented group. A notably higher percentage of patients treated with PRP achieved minimal clinically significant difference in visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) symptom scores. Our trial indicates that percutaneous meniscal trephination augmented with PRP results in a significant improvement in the rate of chronic meniscal tear healing and this procedure decreases the necessity for arthroscopy in the future (8% vs. 28%, P = 0.032).


Assuntos
Traumatismos do Joelho/terapia , Osteoartrite do Joelho/terapia , Plasma Rico em Plaquetas , Lesões do Menisco Tibial/terapia , Administração Cutânea , Adulto , Idoso , Artroscopia/estatística & dados numéricos , Intervalo Livre de Doença , Feminino , Humanos , Traumatismos do Joelho/sangue , Traumatismos do Joelho/patologia , Masculino , Meniscos Tibiais/efeitos dos fármacos , Meniscos Tibiais/cirurgia , Pessoa de Meia-Idade , Osteoartrite do Joelho/sangue , Osteoartrite do Joelho/patologia , Lesões do Menisco Tibial/sangue , Lesões do Menisco Tibial/patologia , Resultado do Tratamento
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