Study: No difference in wound healing for patients who receive PRP after total ankle arthroplasty

Issue: September 2013

PHILADELPHIA — Researchers have found no significant difference in the incidence of complications with the topical application of platelet-rich plasma to incisions after total ankle arthroplasty, according to a study presented at the Musculoskeletal Infection Society Annual Meeting, here.

“Ultimately, [platelet-rich plasma] PRP did not confer any benefit to any patients in any of the groups. With PRP failing to afford protection, we have subsequently stopped using PRP in our institution in routine total ankle arthroplasty,” said Justin M. Kane, MD, of The Rothman Institute at Thomas Jefferson University.

Justin M. Kane

Incision-healing complications present a significant problem in the early postoperative period after total ankle arthroplasty (TAA) with reports of surgical site infection rates that vary from 8% to 34%, Kane said.

Researchers studied 133 consecutive patients who underwent TAA performed by a single surgeon at a single institution in the retrospective chart review. The first 25 patients were excluded from the cohort. In all, 78 patients had incisions sprayed with PRP prior to and following wound closure, while 55 patients did not have PRP augmentation. There was no significant difference in preoperative characteristics. Patients were followed until they either had complete wound healing or underwent a surgical procedure to address complications. Investigators divided patients into three groups based on wound healing: no complications; minor complications that responded to local care; and major complications where the patient returned to operating room.

Overall, 85 patients had no wound complications. Also, 37 patients required prolonged in-office treatment for delayed wound healing, which included 23 patients who received PRP and 14 patients who did not receive PRP. Eleven patients, which included 8 patients who had received PRP, required a second operative procedure for wound healing.

The incidence of wound complications in the PRP group was 10.25%, which was not significantly different when compared to patients who did not receive PRP (5.45%). Of the patients who did not have wound healing complications, 55% had received PRP and 45% had not received PRP.

Reference:

Costanzo JA. The use of PRP and wound healing complications after total ankle arthroplasty. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 2-3, 2013; Philadelphia.

Disclosure: Kane has no relevant financial disclosures.