Platelet-Rich Plasma and Its Analogs Do Not Clinically Improve Functional Outcomes 1 Year After Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Randomized Controlled Trials.

Abstract

To perform a meta-analysis of randomized controlled trials with a minimum 12-month follow-up to determine whether platelet-rich plasma (PRP) improves postoperative functional outcomes after anterior cruciate ligament reconstruction (ACLR). The MEDLINE, Embase, and Cochrane databases were evaluated for studies involving the use of PRP or its analogs in ACLR. Only randomized controlled trials with a follow-up period of 12 months or more 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 the I² statistic. We included 502 patients who underwent ACLR from 9 studies; 251 of these patients were treated with PRP. The mean age ranged from 27.7 to 34.5 years, and the studies reported the participation of 109 female patients. The use of PRP in ACLR resulted in a statistically significant improvement in the International Knee Documentation Committee (IKDC) score after 12 months (mean difference, 2.05; 95% confidence interval, 0.25-3.85; P = .03; I² = 27%). However, there was no statistical significance based on the minimal clinically important difference. No statistically significant differences were found for the Tegner and Lysholm scores at 12 months. This meta-analysis evaluated the effects of PRP and its analogs in ACLR. Functional outcomes were compared after 12 months in both the PRP-enhanced group and the inactive control group. Although the IKDC score showed a statistically significant improvement (P < .05), the Lysholm and Tegner scores did not show significant differences. The statistical difference in the IKDC score, however, did not translate into a clinically significant difference based on the minimal clinically important difference. These findings suggest that although some functional benefits may be observed within the first year after surgery, overall recovery remains variable. Level II, meta-analysis of Level I and II studies.