PLATELET RICH PLASMA (PRP) APPLICATION IN TOTAL KNEE ARTHROPLASTY (TKA)

Abstract

PURPOSE: To find out the PRP application effects in TKA on pain syndrome, wound healing, postoperative blood loss, range of motion and the knee circumference (centimetry). MATERIAL AND METHOD: The preparation of the platelet-rich plasma is based on our treatment algorithm. 20 patients have been subject to TKA within the period from October 2012 to November 2014 and underwent TKA, as platelet rich plasma was used intraoperatively. The average patient age is 72,3; 9 male and 11 female patients. Control group consisted of 17 patients, who underwent surgery in the same period but no platelet rich plasma was used during surgery. Average patient age 73,1; 8 male and 9 female patients. RESULTS: The following results have been reported for the PRP group of patients: the average amount of blood in the aspiration drainage tube in 24 hours - 285 ml.; postoperative pain on the 1st postoperative day was 7 p., on the 5th day - 5 p., on the 10th day - 2 p., average circumference (centimetry) of the knee between the 1st and the 10th postoperative day decreased on average by 1,5-2 cm., range of motion – reported average degrees per patient on the 1st postoperative day in sagittal plane: 010-20 degrees; on the 10th postoperative day: 0-0-55 degrees, surgical wounds of all patients healed primarily without any complications. No PRP group: average amount of blood in the aspiration drainage in 24 hours – 300 pl., postoperative pain on the 1st, 5th , and 10th postoperative day - 8 p., on the 5th day - 6 p., on the 10th day - 3 p., average knee circumference ( centimetry) between 1 and 10 postoperative day has decreased by 1 cm on average, range of motion - reported average degrees per patient on the 1st postoperative day in sagittal plane 0-5-20 degrees, on the 10th: 0-0-50 degrees, surgical wounds healed primarily without any complications in 10 patients, but in 7 patients we observed superficial wound edge skin necrosis. CONCLUSION: Our results unequivocally show that platelet-rich plasma reduces postoperative blood loss and the use of narcotics, improves the range of motion and the circumference of the operated joint and it is crucial for the most common postoperative complications of TKA: namely dermal wound problems.