Effect of platelet-rich plasma on blood coagulation indexes after hip preserving surgery for osteonecrosis of the femoral head / 中国组织工程研究

ABSTRACT

BACKGROUND: It was found that platelet-rich plasma injection can change the coagulation function of patients with osteonecrosis of the femoral head. OBJECTIVE: To investigate the effect of platelet-rich plasma injection on coagulation parameters in patients with osteonecrosis of the femoral head after hip preserving surgery, and to evaluate the risk factors of vascular embolism after surgery. METHODS: Totally 75 cases of osteonecrosis of the femoral head treated by drilling and decompression of the femoral head, removing the dead bone in the femoral head and supporting with fibula allograft were selected in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from December 2016 to September 2018. According to whether platelet-rich plasma injection was used during the operation, the patients were divided into two groups. The platelet-rich plasma group contained 42 cases (42 hips). The control group (33 cases, 35 hips) did not use platelet-rich plasma. The other treatments in the two groups were the same. The changes of blood coagulation indexes before and after operation were continuously observed in the two groups. RESULTS AND CONCLUSION: (1) Patients in both groups were followed up for 3 months. (2) Levels of fibrinogen and D-dimer were significantly increased in both groups. However, levels of fibrinogen and D-dimer in one week after operation in the platelet-rich plasma group were 52.5% and 47.0% higher than those in the control group, indicating platelet-rich plasma led to hypercoagulability and a possible high risk of vascular embolism. (3) There were significant differences in prothrombin time, activated partial thromboplastin time and international standardized ratio, but there was no significant clinical significance in both groups. (4) The use of platelet-rich plasma had no effect on platelet level or C-reactive protein.