Effects of platelet rich plasma along with bone transportation on tibia defect: a randomized controlled clinical trial

Abstract

Objective To investigate the effect of autologous platelet rich plasma along with bone transportation in tibia defect. Methods This was a randomized single-blind placebo controlled clinical trial. From Jan 2013 to Mar 2015, 28 patients (28 cases) suffering from tibia defect because of trauma or osteomyelitis were randomly assigned to PRP group (PRP along with bone transportation, n=15) or bone transportation group (bone transportation only, n=13) through random number table and sealed envelop method. PRP group: male to female 12∶3, average age: 40.9 years old, average bone defect: 7.1 cm, 6 caused by trauma, 9 by osteomyelitis; while bone transportation group: male to female 10∶3, average age: 37.7 years old, average bone defect: 6.5 cm, 3 caused by trauma and 10 by osteomyelitis. Bony results and tibia function were evaluated according to the Association of the Study and Application of the Method of Ilizarov (ASAMI) protocol. The external fixation index, complications and VAS pain score were also evaluated. Results The mean follow-up time was 21.8 m in PRP group and 23.2 m in bone transportation group and there were no loss to follow-up. There were no differences between two groups on postoperative VAS pain score: 1st d postoperative(3.33±2.58 vs 4.46±2.73); 7th d postoperative (2.67±2.09 vs 3.00±2.20); and 2 weeks postoperative (1.46±1.77 vs 2.62±2.72). There was significant difference between two groups on external fixation index (37.9±7.7 d/cm vs 46.9±13.7 d/cm). According to the ASAMI protocol, all patients achieve bone union, except 2 cases in control group which need revision surgery; excellent and good rate of bone defect union was 93% in PRP group while 77% in control group; while no difference was found on complication and lower extremity function. Conclusion Application of PRP along with bone transportation in the treatment of tibia defect re-sults in shorter healing duration and external fixation duration. But no short-term postoperative analgesic effect, lower extremity function, and complication rates were found. Key words: Platelet-rich plasma; Osteogenesis, distraction; External fixators; Ilizarov technique