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Table 1 Synopsis of all the clinical studies on PRP application in ankle cartilage pathology

From: Platelet-rich plasma to treat ankle cartilage pathology - from translational potential to clinical evidence: a systematic review

AUTHORS, JOURNAL AND YEAR LEVEL OF EVIDENCE PATHOLOGY PRP features PROTOCOL PATIENTS FOLLOW- UP OUTCOME
Mei-Dan et al. AJSM 2012 [17] I – Randomized trial Osteochondral lesions of the talus Leukocyte-poor PRP 3 injections of 2 ml PRP, at two-weeks interval 30 (15 PRP vs 15 HA) 7 months Statistically significant better clinical outcome for PRP group
Single centrifugation
Platelet count: 2-3x basal value
Activation: Ca-chloride
Angthong et al. J Foot Ankle Surg 2013 [18] IV – Case series Ankle OA Low platelet concentrate, leukocyte poor PRP One injection of 3 ml PRP 5 16 months Significant clinical improvement without any change in OA grade
Single centrifugation
Activation: No
Guney et al. KSTTA 2013 [19] II – Randomized trial Osteochondral lesion of the talus Platelet count: 5.4x basal value One PRP injection (6–24 hours after performing microfractures) 35 (19 microfractures + PRR vs 15 microfractures alone) 16 months Combined treatment with PRP determined significantly better outcomes in terms of functional scores with respect to bone marrow stimulation alone.
Leukocyte: n.a.
10% NAHCO3 addition before PRP injection
Giannini et al. Clin Orthop Rel Res 2009 [20] IV – case series Osteochondral lesion of the talus Double centrifugation, leukocyte rich PRF PRP added intra-operatively to the biomaterial during the osteochondral lesion repair 48 24 months Significant improvement in the AOFAS score of the patietns treated at final FU. 75% of the patients were able to resume sports activity. Cartilage with hyaline appearance in the 2 second look biopsies performed.
Platelet count 5x basal value
Giannini et al. Injury 2010 [21] III – retrospective comparative trial Osteochondral lesion of the talus   PRP added intra-operatively to the biomaterial during the osteochondral lesion repair 81 (25 one step technique with PRP vs 10 open ACI vs 46 arthroscopic ACI) 36 months All the 3 groups had similar patterns of clinical improvement. The one step technique was cheaper.
Battaglia et al. Eur J Radiol 2011 [22] IV – case series Osteochondral lesion of the talus   PRP added intra-operatively to the biomaterial during the osteochondral lesion repair 20 24 months Regenerated tissue with a T2 relaxation time value comparable to hyalinecartilage was found in all the treated cases, covering a mean of 78% of the repaired lesion area.
Giannini et al. Am J Sports med 2013 [23] IV – case series Osteochondral lesion of the talus   PRP added intra-operatively to the biomaterial during the osteochondral lesion repair 49 48 months A significant relationship between the AOFAS score at 48 months’ follow-up and the percentage of regenerated cartilage with hyaline features (T2 value of 35–45 ms). Patients with hyaline-like regenerated cartilage in more than 80% of the treated area had a more predictable and stable result.