gms | German Medical Science

Objectives: The aim of this study was to compare clinical results of treatment of knee cartilage injuries using arthroscopic microfracture technique alone or in combination with postoperative intraarticular autologous platelet-rich plasma (PRP) injections.

Methods: A comparative prospective study was performed. Clinical outcomes were assessed in 55 patients with posttraumatic articular cartilage defects of the knee (grade III-IV according to Outerbridge's classification). At baseline 24 patients (control group) had undergone arthroscopic microfracture procedure. 31 patients in addition were treated with postoperative intraarticular injections of PRP (PRP- group). To prepare PRP single centrifugation protocol was used. The clinical progress was assessed by using the Knee injury and Osteoarthritis Outcome Score (KOOS) at baseline, 6, 12 and 24 months. Data are presented as the arithmetic mean with standard error. To determine differences between groups the Mann-Whitney U test was used. P < 0.05 was considered significant.

Results and Conclusion: The PRP- group average age was 29+6 years (control group - 30+8 years). In all cases the KOOS showed significant improvement at 1 and 2 year after surgery comparing with the preoperative condition. At 1 year follow-up the KOOS was significantly higher in the subclasses "symptoms" (p<0.01), "function in daily living" (p<0.01), "function in sport and recreation" (p<0.01) and "knee-related quality of life" (p<0.01) in patients treated with platelet-rich plasma comparing with the control group. At 2 year follow-up the KOOS was significantly higher only in the subclasses "function in sport and recreation" (p<0.01) and "knee-related quality of life" (p<0.05) in PRP- group comparing with the control.

Combination of microfracture and postoperative intraarticular autologous PRP injections improve the results of knee cartilage injuries treatment. However, more data and long-term follow-up are still needed.