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Plasma Rich in Growth Factors to Treat an Articular Cartilage Avulsion: A Case Report

SÁNCHEZ, MIKEL1; AZOFRA, JUAN1; ANITUA, EDUARDO2; ANDÍA, ISABEL3; PADILLA, SABINO4; SANTISTEBAN, JUANMA4; MUJIKA, IÑIGO4

Medicine & Science in Sports & Exercise: October 2003 - Volume 35 - Issue 10 - p 1648-1652
doi: 10.1249/01.MSS.0000089344.44434.50
CLINICAL SCIENCES: Clinical Case Studies

SÁNCHEZ, M., J. AZOFRA, E. ANITUA, I. ANDÍA, S. PADILLA, J. SANTISTEBAN, and I. MUJIKA. Plasma Rich in Growth Factors to Treat an Articular Cartilage Avulsion: A Case Report. Med. Sci. Sports Exerc., Vol. 35, No. 10, pp. 1648–1652, 2003.

Introduction The application of an autologous plasma rich in growth factors is beneficial in restoring connective tissues, as shown by clinical evidence in oral surgery and more recently in arthroscopic anterior cruciate ligament reconstruction and two cases of ruptured Achilles tendon in professional athletes. This is attributed to the slow delivery of growth factors from harvested platelets that have been activated by endogenous thrombin promoted by the addition of calcium chloride.

Purpose This case report describes a new application of this therapy in the arthroscopic treatment of a large, nontraumatic avulsion of articular cartilage in the knee of an adolescent soccer player.

Methods After arthroscopic reattachment of the large (>2 cm) loose chondral body in its crater in the medial femoral condyle, autologous plasma rich in growth factors was injected into the area between the crater and the fixed fragment.

Results and Conclusion Despite the extremely poor prognosis of the case, complete articular cartilage healing was considerably accelerated, and the functional outcome was excellent, allowing a rapid resumption of symptom-free athletic activity. This technique opens new perspectives for human tissue regeneration.

1Arthroscopic Surgery Unit, USP-La Esperanza Clinic, Vitoria-Gasteiz, Basque Country, SPAIN;

2B.T.I. Biotechnology Institute, Vitoria-Gasteiz, Basque Country, SPAIN;

3Department of Neurochemistry Research, Osakidetza–Basque Health Service, Zamudio, Basque Country, SPAIN; and

4Department of Research and Development, Medical Services, Athletic Club of Bilbao, Basque Country, SPAIN

Address for correspondence: Iñigo Mujika, Ph.D., Mediplan Sport S.L., Obdulio López de Uralde 4, bajo, 01008 Vitoria–Gasteiz, Basque Country, Spain; E-mail: imujika@grn.es.

Submitted for publication December 2002.

Accepted for publication June 2003.

©2003The American College of Sports Medicine