Joost Peerbooms

37 PRP after total knee arthroplasty INTRODUCTION Identification of methods to enhance or accelerate wound healing may be important, especially in high-risk patients (e.g., with type 1 diabetes mellitus, tobacco use, or previously irradiated tissue). The requirement of growth factors within the wound healing cascade has been confirmed. 1, 15, 16 In a canine model, treatment with autologous blood platelet concentrate enhanced and accelerated early wound healing. 22 In humans autologous blood platelet concentrate was shown to increase bone formation in maxillofacial surgery. 18 Since this latter result was regarded as a general stimulation of repair rather than a specific increase in bone formation, we investigated in a double- blind randomized trial whether the application of a platelet concentrate (in spray form) could improve repair of wounds after TKA. The primary outcome parameter was wound healing, but we also studied the effects on knee function, use of analgesics, and haemoglobin values. PATIENTS AND METHODS This double-blind, randomized study included 102 consecutive patients scheduled for primary unilateral TKA for osteoarthritis between June 2005 and March 2007. All procedures took place in a training hospital using the same surgical procedure performed by an orthopaedic consultant or a supervised senior orthopaedic resident. There was no age limit for inclusion. Criteria for participation included pain and radiographic knee osteoarthritis. Exclusion criteria were: platelet count ≤ 150x10 9 /L, haemoglobin level ≤ 6.5 mmol/L, BMI > 33 and systemic disorders such as diabetes, rheumatoid arthritis and hepatitis. In the current study we tested the hypothesis that the application of a platelet concentrate (in spray form) could improve repair of wounds after TKA. The primary endpoint was wound healing, but we also studied the effects on knee function, use of analgesics, and haemoglobin values. 3