The Effects of Platelet-Rich Plasma and Activated Collagen on Wound Healing in Primary Total Joint Arthroplasty.

Abstract

Wound healing remains a concern in primary total joint arthroplasty, given the risk of deep infections arising from hematomas, wound separations, and superficial infections. If wound additives can prevent these early complications, their universal application would be cost-effective. This study examined whether 2 wound additives, platelet-rich plasma (PRP) and activated collagen, would improve postoperative wound healing and reduce complications in primary total joint arthroplasty. A prospective, randomized controlled study was conducted using 3 cohorts with 30 patients each (group 1: PRP; group 2: activated collagen; and group 3: control). These patients were examined at 2 and 6 weeks postoperatively, at which time the following data were recorded: 6 wound measurements, total postoperative blood loss, complications of superficial infections, and reoperations. The PRP and the activated collagen groups showed early improvement in 3 of the 6 wound scores at 2 weeks, but these early results were not present at 6 weeks. In addition, there was a statistically significant reduction in blood loss in both the PRP and the activated collagen groups, as compared with the control group. Furthermore, high-risk patients had a statistically significant reduction in total complication rates in both the PRP and the activated collagen groups, as compared with the control group. On the basis of this study, these additives are not recommended for routine primary joint arthroplasty; however, the data suggest possible benefits for high-risk patients and those for whom blood loss may be an issue. [Orthopedics. 2018; 41(2):e262-e267.].