Joost Peerbooms

38 Chapter 3 Figure 1. Flow chart of the patients. Randomization Block randomization of the patients was performed after they were deemed eligible and had provided informed consent. Patients were randomly allocated to the PG armor to the C arm. Treatment assignments (placed in sequentially numbered opaque envelopes) were assigned by the trial managers, who also arranged the facilities needed for the procedure. Surgical procedure The medial para-patellar approach was used, averting the patella laterally. A tourniquet was used. In all cases a cemented posterior cruciate retaining prosthesis (AGC; Biomet Biologics, Warsaw, Indiana) was used. After implantation of the components, the tourniquet was deflated, and primary haemostasis was achieved. Before closure of the wound layers, the knee soft tissues and joint were rinsed with saline solution to remove all debris. After closure of the joint capsule the subcutaneous tissues of the patients randomized to receive PG were sprayed with the platelet-poor plasma (PPP) fraction (±10 mL), and the skin was closed with staplers. We did not use a deep or subcutaneous drain. In all patients the knee incision was dressed postoperatively with compression bandages and rehabilitation was started the day after surgery. In this fashion, patients, nurses and physical therapist were all blinded to which procedure was used.