Saratov JOURNAL of Medical and Scientific Research

Comparative analysis of surgical outcomes for achondroplasic children receiving PRP-therapy (a case-control study)

Year: 2020, volume 16 Issue: №3 Pages: 757-761
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Timaev M.Kh., Sertakova A.V., Alieva A.V.
Organization: Saratov State Medical University

Objective: To assess surgical outcomes in achondroplasic pediatric patients receiving PRP-therapy (Platelet-Rich Plasma therapy) for lengthening long bones. Material and Methods: 27 achondroplasic patients had been examined and operated in the pediatric trauma orthopedic department of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n. a. V.I. Rasumovsky in 2014-2018, their mean age 4.7±2.1 у. o. (4-11 у. o. range). The examination involved conventional clinical examination as well as X-ray examination. All patients were divided into 2 groups, the division criteria being intraoperative application of PRP-therapy (autoplasma therapy or plasmolifting). Group 1 (n=14) was made up of patients who had underwent transosseous compression distraction osteosynthesis with no PRP employed while all patients of Group 2 (n=13) had received PRP injections. Results: The distraction consolidation index (DCI) in Group 1 (n=14) was 72±7 days/cm (good and satisfactory results) and the average length of the grown distraction was 4.5±2.5 cm. In PRP-therapy employed Group 2 DCI was 65±10 days/cm (good results) and the distraction length was 6.5±2.5 cm. In patients of Group 1 sectioned, lateral and central forms of the distraction prevailed while in patients who had received PRP-therapy spindle and cylinder forms of the distraction were observed. Conclusion: PRP-therapy employed in all stages of the elective distraction at limb osteotomy allows significant DCI improvement as well as activation of bone tissue remodeling in the osteotomy area, the geometric type of trabeculae formation being more beneficial.

1. Ornitz DM, Legeai-Mallet L. Achondroplasia: Development, Pathogenesis, and Therapy. Developmental dynamics 2017; (246): 291-309. DOI: 10.1002/DVDY. 24479.
2. Unger S, Bonafe L, Gouze E. Current Care and Investigational Therapies in Achondroplasia. Curr Osteoporos Rep 2017; (2): 53-60. DOI: 10.1007/s11914-017-0347-2.
3. Diachkova GV, Aranovich AM, Diachkov KA, et al. Orthopaedic, psychological, social and philosophical aspects of achondroplasia patients treated with the llizarov method. Genij Ortopedii 2018; 24 (4): 465-73.
4. ShchukinAA, Aranovich AM, PopkovAV, etal. Evaluation of the results of lower limb lengthening in patients with systemic skeletal diseases accompanied by pathologically short stature. Genij Ortopedii 2014; (2): 44-51.
5. Псе МР, Miller JC, Hannon СР, et al. The Role of platelet-rich plasma in cartilage pathology: an updated systematic review of the basic science evidence. Arthroscopy 2019; 35 (3): 961-76. DOI: 10.1016/j. arthro. 2018.10.125.
6. Goddard NV, Waterhouse N. Regenerative medicine, stem cell therapies, and platelet-rich plasma: where is the evidence? Aesthetic Surgery Journal 2020; 40 (4): 460-5. DOI: 10.1093/asj/sjz317.
7. Murphy RF, Mooney JF. Orthobiologics in pediatric orthopedics. Orthop Clin North Am 2017; 48 (3): 323-31. DOI: 10.1016/j. ocl. 2017.03.007.
8. Li R, Saleh M, Yang L, et al. Radiographic classification of osteogenesis during bone distraction. J Orthop Res 2006; 24 (3): 339-47. DOI: 10.1002/jor. 20026.
9. Alves R, Grimalt RA. Review of platelet-rich plasma: history, biology, mechanism of action, and classification. Skin Appendage Disord 2018; 4(1): 18-24. DOI: 10.1159/000477353.
10. Andia I, Abate M. Platelet-rich plasma: underlying biology and clinical correlates. Regen Med 2013; (8): 645-58. DOI: 10.2217/rme. 13.59.
11. Andia I. Platelet-rich plasma biology. In: Alves R, Grimalt R., eds. Clinical Indications and Treatment Protocols with Platelet-Rich Plasma in Dermatology. Barcelona: Ediciones Mayo, 2016; p. 3-15.
12. Rughetti A, Giusti I, D'Ascenzo S, et al. Platelet gel-released supernatant modulates the angiogenic capability of human endothelial cells. Blood Transfus 2008; (6): 12-7. DOI: 10.2450/2008.0026-07.
13. Dhurat R, Sukesh MS. Principles and methods of preparation of platelet-rich plasma: a review and author's perspective. J Cutan Aesthet Surg 2014; 7 (4): 189-97. DOI: 10.4103/0974-2077.150734.
14. Klymovytskyi VH, Soloviov IA. The use of platelet-rich plasma in the treatment of soft and bone tissue injuries (review). Trauma 2015; 16 (6): 77-80.
15. Roffi A, Matteo BD, Krishnakumar GS, et al. Platelet-rich plasma for the treatment of bone defects: from pre-clinical rational to evidence in the clinical practice. A systematic review. International Orthopedics 2017; 41 (2): 221-37. DOI: 10.1007/S00264-016-3342-9.
16. Malygina MA, Borovkova NV, Sakharova OM, et al. The use of platelet rich plasma in diseases and injuries of the musculoskeletal system. Transplantology 2017; 9 (4): 325-34.
17. Kesyan GA, Berchenko GN, Urazgildeev RZ, et al. Combined application of platelet-rich plasma and biocomposite material collapan in complex treatment of patients with non-united fractures and pseudarthrosis of extremity long bones. N.N. Priorov Journal of Traumatology and Orthopedics 2011; (2): 26-32.
18. ObolenskijVN, Ermolova DA, MakarovMS. Regeneration processes stimulation for chronic wounds using PRP: clinical experimental study. Clinical and Experimental Surgery. Petrovsky journal 2016; (1): 38-43.
19. Vade A, Eissenstat R. Radiographic features of bone lengthening procedures. Radiology 1990; (174): 531-7.
20. Eyres KS, Bell MJ, Kanis JA. Methods of assessing new bone formation during limb lengthening. Ultrasonography, dual energy X-ray absorptiometry and radiography compared. J Bone Joint Surg 1993; (75): 358-64.
21. Minty I, Maffulli N, Hughes TH. Radiographic features of limb lengthening in children. Acta Radiol 1994; (35): 555-9.

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