Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2019

Open Access 01-12-2019 | Magnetic Resonance Imaging | Case report

Platelet-rich plasma combined with allograft to treat osteochondritis dissecans of the knee: a case report

Authors: Mikel Sánchez, Diego Delgado, Ane Garate, Pello Sánchez, Sabino Padilla, Juan Azofra

Published in: Journal of Medical Case Reports | Issue 1/2019

Login to get access

Abstract

Background

Osteochondritis dissecans of the knee is a prevalent pathology in young, active people that is brought about by either traumatic, developmental, or iatrogenic etiologies.

Case presentation

A 40-year-old Caucasian man reporting pain, swelling, and functional reduction was evaluated and diagnosed with internal condyle osteochondritis dissecans of the knee. Harnessing the trophic, chondroprotective, anti-inflammatory, and immunomodulatory properties of platelet-rich plasma, we carried out a knee open-sky surgical technique in which we combined autologous therapy with osteochondral allograft to treat the focal, large, and deep traumatic-iatrogenic osteochondritis dissecans of the knee. The axial computed tomographic scan taken 1 year after surgery revealed an area of abnormal signal intensity that was reduced on a computed tomographic scan 2 years later. The computed tomographic scan obtained 2 years later and the magnetic resonance imaging scan 3 years later also showed a clear reattachment and incorporation of the graft. Seven years after the surgery, the patient resumed his daily routine without any recurrent symptoms.

Conclusion

Platelet-rich plasma application in osteochondral allograft implantation open surgery could enhance the healing process of medial condyle osteochondritis dissecans of the knee.
Literature
1.
go back to reference Cole BJ, Pascual-Garrido C, Grumet RC. Surgical management of articular cartilage defects in the knee. J Bone Joint Surg Am. 2009;91(7):1778–90.PubMed Cole BJ, Pascual-Garrido C, Grumet RC. Surgical management of articular cartilage defects in the knee. J Bone Joint Surg Am. 2009;91(7):1778–90.PubMed
2.
go back to reference Sánchez M, Fiz N, Azofra J, et al. A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy. 2012;28(8):1070–8.CrossRef Sánchez M, Fiz N, Azofra J, et al. A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy. 2012;28(8):1070–8.CrossRef
3.
go back to reference Thomson NL. Osteochondritis dissecans and osteochondral fragments managed by Herbert compression screw fixation. Clin Orthop Relat Res. 1987;(224):71–8. Thomson NL. Osteochondritis dissecans and osteochondral fragments managed by Herbert compression screw fixation. Clin Orthop Relat Res. 1987;(224):71–8.
4.
go back to reference Anitua E, Sanchez M, Nurden AT, et al. Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford). 2007;46(12):1769–72.CrossRef Anitua E, Sanchez M, Nurden AT, et al. Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford). 2007;46(12):1769–72.CrossRef
5.
go back to reference Braun HJ, Kim HJ, Chu CR, Dragoo JL. The effect of platelet-rich plasma formulations and blood products on human synoviocytes: implications for intra-articular injury and therapy. Am J Sports Med. 2014;42(5):1204–10.CrossRef Braun HJ, Kim HJ, Chu CR, Dragoo JL. The effect of platelet-rich plasma formulations and blood products on human synoviocytes: implications for intra-articular injury and therapy. Am J Sports Med. 2014;42(5):1204–10.CrossRef
6.
go back to reference Spreafico A, Chellini F, Frediani B, et al. Biochemical investigation of the effects of human platelet releasates on human articular chondrocytes. J Cell Biochem. 2009;108(5):1153–65.CrossRef Spreafico A, Chellini F, Frediani B, et al. Biochemical investigation of the effects of human platelet releasates on human articular chondrocytes. J Cell Biochem. 2009;108(5):1153–65.CrossRef
7.
go back to reference van Buul GM, Koevoet WL, Kops N, et al. Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes. Am J Sports Med. 2011;39(11):2362–70.CrossRef van Buul GM, Koevoet WL, Kops N, et al. Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes. Am J Sports Med. 2011;39(11):2362–70.CrossRef
8.
go back to reference Caplan AI. Adult mesenchymal stem cells for tissue engineering versus regenerative medicine. J Cell Physiol. 2007;213(2):341–7.CrossRef Caplan AI. Adult mesenchymal stem cells for tissue engineering versus regenerative medicine. J Cell Physiol. 2007;213(2):341–7.CrossRef
9.
go back to reference Koelling S, Kruegel J, Irmer M, et al. Migratory chondrogenic progenitor cells from repair tissue during the later stages of human osteoarthritis. Cell Stem Cell. 2009;4(4):324–35.CrossRef Koelling S, Kruegel J, Irmer M, et al. Migratory chondrogenic progenitor cells from repair tissue during the later stages of human osteoarthritis. Cell Stem Cell. 2009;4(4):324–35.CrossRef
10.
go back to reference Bendinelli P, Matteucci E, Dogliotti G, et al. Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: mechanisms of NF-κB inhibition via HGF. J Cell Physiol. 2010;225(3):757–66.CrossRef Bendinelli P, Matteucci E, Dogliotti G, et al. Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: mechanisms of NF-κB inhibition via HGF. J Cell Physiol. 2010;225(3):757–66.CrossRef
11.
go back to reference Sundman EA, Cole BJ, Karas V, et al. The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis. Am J Sports Med. 2014;42(1):35–41.CrossRef Sundman EA, Cole BJ, Karas V, et al. The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis. Am J Sports Med. 2014;42(1):35–41.CrossRef
Metadata
Title
Platelet-rich plasma combined with allograft to treat osteochondritis dissecans of the knee: a case report
Authors
Mikel Sánchez
Diego Delgado
Ane Garate
Pello Sánchez
Sabino Padilla
Juan Azofra
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2019
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-019-2027-6

Other articles of this Issue 1/2019

Journal of Medical Case Reports 1/2019 Go to the issue