Platelet-rich Plasma Does Not Reduce Blood Loss or Pain or Improve Range of Motion After TKA

Background Numerous reports suggest the application of platelet-rich plasma (PRP) during TKA may decrease postoperative bleeding. Because excessive bleeding can increase postoperative pain and inflammation, use of PRP also reportedly decreases the need for narcotics and increases speed of recovery after TKA. Because previous investigations of PRP and TKA reflect a weak level of medical evidence, we sought to confirm these findings.

Questions/purposes We asked whether an intraoperative application of PRP gel to the deep wound reduced postoperative bleeding after TKA.

Methods We retrospectively reviewed the charts of all 134 patients who received an intraoperative application of PRP during TKA from November 2009 to April 2010 and all 139 patients undergoing TKA who did not receive PRP between September 2009 to November 2009. Patients’ charts were reviewed to identify detailed data, including hemoglobin level, ROM, postoperative narcotic use, and length of hospital stay. Blood loss was determined by the hemoglobin drop on postoperative Day 2.

Results The blood loss between study groups was similar (3.6 g/dL [study] versus 3.8 g/dL [controls]). Differences in passive ROM (88° versus 88°), narcotic requirement (27 versus 32 morphine equivalent), and length of stay (2.4 versus 2.6 days) were also similar.

Conclusion We found no clinically important differences in patients who received an intraoperative application of PRP compared with patients who did not receive PRP and therefore could not confirm the findings of previous studies.

Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.