Clinical outcomes of platelet rich plasma (PRP) as an adjunct to microfracture surgery in osteochondral lesions of the talus.

ABSTRACT

PURPOSE: To compare the effect of arthroscopic microfracture surgery alone or in combination with platelet rich plasma (PRP) on functional outcomes in osteochondral lesions of the talus. METHODS: A total of 35 patients were included in the study. Control subjects (n = 16) received treatment with microfracture surgery alone, while the remaining patients (PRP group, n = 19) were also given PRP. After an average follow-up of 16.2 months (range 12-24 months), patients were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system, Foot and Ankle Ability Measure (FAAM), and the visual analogue scale (VAS) for pain. RESULTS: At baseline, AOFAS and FAAM scores were similar in the two groups, whereas pain scores (VAS) were higher in those who were assigned to combined treatment. Despite the latter finding, the combined treatment with PRP resulted in better outcomes in terms of functional scores [AOFAS, 89.2 ± 3.9 vs. 71.0 ± 10.2, (p = 0.001); FAAM overall pain domain, 1.0 (1.0-2.0) vs. 2.5 (1.0-4.0), (p = 0.04); FAAM 15-min walking domain, 1.0 (1.0-2.0) vs. 2.0 (1.0-4.0) (p = 0.001)]; and pain-related scores [VAS, 2.2 ± 0.8 vs. 3.8 ± 1.2, (p = 0.001)] as compared to arthroscopic microfracture surgery alone. CONCLUSIONS: PRP as an adjunct to arthroscopic microfracture surgery for the treatment of osteochondral lesions of the talus resulted in improved functional score status in the medium-term. Further studies to determine the long-term efficacy of this approach were warranted. LEVEL OF EVIDENCE II.