Platelet-rich plasma for the reduction of blood loss after total knee arthroplasty: a clinical trial

Purpose This study aims to clarify the effect of intra-articular platelet-rich plasma (PRP) in total knee arthroplasty (TKA) in preventing postoperative bleeding. Methods There were 315 knees that underwent TKA and were included in this study. The subjects were randomized by paramedical staffs. These were divided into the PRP group who received intra-articular PRP intraoperatively ( n = 109) and the control group who did not ( n = 206). We measured postoperative blood loss (drain bag volume), estimated blood loss, and change in hemoglobin (Hb) value at postoperative day 1, 2, 4, and 7. The clinical data were compared between the PRP group and the control group. Results The mean postoperative blood loss of 446.9 ± 149.7 mL in the PRP group was significantly less than that in the control group (550.7 ± 178.1 mL, p < 0.001). The mean postoperative estimated blood loss of 437.5 ± 221.3 mL in the PRP group was significantly less than that in the control group (552.2 ± 336.3 mL, p < 0.01). The mean change in Hb value (mg/dL) from baseline was −1.45 in the PRP group and −1.85 in the control group at postoperative 1 day ( p < 0.05), −1.74 in the PRP group and −2.11 in the control group at postoperative day 2 ( p < 0.05), −2.30 in the PRP group and −2.47 in the control group at postoperative day 4 ( p < 0.05), and −1.98 in the PRP group and −2.46 in the control group at postoperative day 7 ( p < 0.01). Conclusion In this prospective randomized study, those that received PRP after TKA had significantly less postoperative blood loss and change in Hb level. PRP appears to be effective in reducing postoperative bleeding in TKA.