Platelet-Rich Plasma and Its Analogues Does Not Clinically Improve Functional Outcomes One Year After ACL Reconstruction: A Meta-Analysis of Randomized Controlled Trials.

Abstract

Purpose: To evaluate with a meta-analysis of randomized controlled trials (RCT) of at least 12 months the current controversy if platelet-rich plasma (PRP) improves postoperative functional outcomes in anterior cruciate ligament reconstruction (ACLR).

Methods: The MEDLINE, EMBASE and COCHRANE databases were evaluated for studies involving the use of PRP or its analogues in ACLR. Only RCTs with a follow-up of 12 months or more and that presented only PRP as an intervention were selected. Statistical analysis was performed using R software (Version 4.4.1) and heterogeneity was assessed using I².

Results: We included 502 patients from 9 studies submitted to ACLR, with 251 treated with PRP. The mean age varied from 27.7 to 34.5 years, and the studies reported the participation of 109 females The use of PRP in ACL reconstruction resulted in a statistically significant improvement in the International Knee Documentation Committee (IKDC) score after 12 months (MD = 2.05; 95% CI = 0.25 - 3.85; p = 0.03; I² = 27%). However, based on the Minimal Clinically Important Difference (MCID), there was no statistical significance. No statistically significant difference was found for the Tegner and Lysholm score at 12 months.

Conclusion: This meta-analysis evaluated the effects of PRP and its analogues in ACLR . Functional outcomes were compared after 12 months in both PRP enhanced group and inactive control. While the IKDC score demonstrated a statistically significant improvement (p < 0.05), the Lysholm and Tegner scores did not show significant differences. The statistical difference, however, did not translate into clinically significant differences based on the MCID. These findings suggest that although some functional benefits may be observed within the first year post-surgery, overall recovery remains variable.