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Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

In this study we describe the potential role of autologous platelet gel and fibrin sealant in unilateral total knee arthroplasty to improve the postoperative range of motion and to reduce the incidence of arthrofibrosis. Total knee arthroplasty is often associated with a considerable amount of post-operative blood loss. Persistent limited motion directly after surgery may ultimately result in arthrofibrosis. To counteract these effects we investigated whether the use of autologous derived platelet gel and fibrin sealant would reduce postoperative blood loss, decrease the impaired range of motion and the incidence of arthrofibrosis. All patients were consecutively operated and assigned to the study or control groups. Study group patients (n = 85) were treated with the application of autologous platelet gel and fibrin sealant at the end of surgery. Eighty patients were operated without the use of platelet gel and fibrin sealant, and served as the control group. The postoperative hemoglobin decrease, range of motion and length of hospitalization were recorded. During a 5-month postoperative period patients were followed to observe the incidence of arthrofibrosis. In patients in the treatment group the hemoglobin concentration in blood decreased significantly less when compared to the control group. They also showed a superior postoperative range of motion when compared to those of the control group (P < 0.001). The incidence of arthrofibrosis and subsequent forced manipulation was significantly less (P < 0.001) in patients managed with platelet gel and fibrin sealant. We conclude that peri-operatively applied platelet gel and fibrin sealant may improve the range of motion after total knee arthroplasty, decreases the length of stay and may reduce the incidence of arthrofibrosis.

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Acknowledgments

The authors wish to thank Mr. G. van Dael and M. Roelofs for the preparation of the Figs. 1, 2, and 3.

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Authors and Affiliations

  1. Department of Peri-Operative Blood Management, Catharina Hospital, Eindhoven, The Netherlands

    Peter A. M. Everts

  2. Department of Orthopaedic Surgery-Traumatology, Catharina Hospital, Eindhoven, The Netherlands

    Roger J. J. Devilee, Cornelis J. M. Oosterbos & Maarten Eeftinck Schattenkerk

  3. Business Schools of Management and Statistics, Hamline University, St Paul, MN, USA

    Christine Brown Mahoney

  4. Department of Anesthesiology, University Medical Centre, Utrecht, The Netherlands

    Johannes T. A. Knape

  5. Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands

    André van Zundert

  6. Department of ECC/BM, Catharina Hospital, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands

    Peter A. M. Everts

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  1. Peter A. M. Everts
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Correspondence to Peter A. M. Everts.

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Everts, P.A.M., Devilee, R.J.J., Oosterbos, C.J.M. et al. Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis. Knee Surg Sports Traumatol Arthr 15, 888–894 (2007). https://doi.org/10.1007/s00167-007-0296-x

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