The Influence of Platelet-Rich Fibrin on the Healing of Bone Defects after Harvesting Bone-Patellar Tendon-Bone Grafts

Darko Milovanovic; Petar Vukman; Dusica Gavrilovic; Ninoslav Begovic; Lazar Stijak; Svetlana Sreckovic; Marko Kadija

doi:10.3390/medicina60010154

The Influence of Platelet-Rich Fibrin on the Healing of Bone Defects after Harvesting Bone-Patellar Tendon-Bone Grafts

Medicina (Kaunas). 2024 Jan 15;60(1):154. doi: 10.3390/medicina60010154.

Authors

Darko Milovanovic^{1

2}, Petar Vukman¹, Dusica Gavrilovic³, Ninoslav Begovic^{2

4}, Lazar Stijak², Svetlana Sreckovic^{1

2

5}, Marko Kadija^{1

2}

Affiliations

¹ Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia.
² School of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia.
³ Institute for Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, Serbia.
⁴ Institute for Mother and Child Health Care of Serbia, Radoja Dakica 6-8, 11070 Belgrade, Serbia.
⁵ Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia.

Abstract

Background and Objectives: A bone-patellar tendon-bone (BTB) autograft in anterior cruciate ligament reconstruction (ACLR) is still considered the gold standard among many orthopedic surgeons, despite anterior knee pain and kneeling pain being associated with bone defects at the harvest site. Bioregenerative products could be used to treat these defects, perhaps improving both the postoperative discomfort and the overall reconstruction. Materials and methods: During a year-long period, 40 patients were enrolled in a pilot study and divided into a study group, in which bone defects were filled with Vivostat^® PRF (platelet-rich fibrin), and a standard group, in which bone defects were not filled. The main outcome was a decrease in the height and width of the bone defects, as determined by magnetic resonance imaging on the control exams during the one-year follow-up. The secondary outcomes included an evaluation of kneeling pain, measured with a visual analog scale (VAS), and an evaluation of the subjective knee scores. Results: The application of Vivostat^® PRF resulted in a more statistically significant reduction in the width of the defect compared with that of the standard group, especially at 8 and 12 months post operation (p < 0.05). Eight months following the surgery, the study group's anterior knee pain intensity during kneeling was statistically considerably lower than that of the standard group (p < 0.05), and the statistical difference was even more obvious (p < 0.01) at the last follow-up. Each control examination saw a significant decrease in pain intensity in both the groups, with the values at each exam being lower than those from the prior exam (p < 0.01). A comparison of subjective functional test results 12 months post operation with the preoperative ones did not prove a statistically significant difference between the groups. Conclusions: The use of Vivostat^® PRF reduces kneeling pain and accelerates the narrowing of bone defects after ACLR with a BTB graft, but without confirmation of its influence on the subjective knee score.

Keywords: ACL reconstruction; BTB graft; kneeling pain; platelet-rich fibrin.

MeSH terms

Bone-Patellar Tendon-Bone Grafts
Humans
Pain
Pilot Projects
Platelet-Rich Fibrin*
Transplantation, Autologous

Grants and funding

This research received no external funding.