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Purpose <p>Platelet-rich plasma (PRP) is a promising treatment for enhancing the outcomes of bone marrow stimulation for osteochondral lesions of the talus (OLT) and has demonstrated efficacy in alleviating symptoms due to its biological properties. However, the role of leukocyte concentration in PRP remains unclear, particularly regarding cartilage regeneration. This study aimed to compare the clinical outcomes and time to return to activity between leukocyte-poor PRP (LP-PRP) and leukocyte-rich PRP (LR-PRP) in OLT surgery.</p> Methods <p>Data from 29 patients with ≥ two year follow-up were retrospectively reviewed: 18 who received LP-PRP and 11 who received LR-PRP with OLT surgery. The study assessed the timeline of return to activity and Self-Managed Foot Evaluation Questionnaire (SAFE-Q) scores preoperatively and at three months, six months, and two years postoperatively.</p> Results <p>The LP-PRP group resumed jogging and sports significantly earlier than the LR-PRP group (<i>P</i> = 0.03, <i>P</i> &lt; 0.01). No patients in either group experienced complications. Both groups showed improved SAFE-Q scores at six months, but at two years, the LP-PRP group maintained significantly higher scores compared to their preoperative levels, whereas the LR-PRP group showed declines in some domains.</p> Conclusion <p>LP-PRP enabled an earlier return to sports compared with LR-PRP. Additionally, LP-PRP maintained good clinical scores two years after surgery. In contrast, the LR-PRP group showed some decline from their early postoperative peak, although absolute scores remained above preoperative levels. These findings suggest that LP-PRP may be an effective adjuvant treatment for OLT surgery.</p> Level of evidence <p>III.</p>

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Comparison of the effects of leukocyte-rich and leukocyte-poor platelet-rich plasma following bone marrow stimulation technique on osteochondral lesions of the talus in athletes: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年11月27日

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  • Taihei Miura,
  • Benny Ewe Boon Yeow,
  • Yasuyuki Jujo,
  • Kosui Iwashita,
  • Parthiban Sivasamy,
  • Kazuaki Okugura,
  • Yukinori Mori,
  • Kenta Komesu,
  • Masato Takao

摘要

Purpose

Platelet-rich plasma (PRP) is a promising treatment for enhancing the outcomes of bone marrow stimulation for osteochondral lesions of the talus (OLT) and has demonstrated efficacy in alleviating symptoms due to its biological properties. However, the role of leukocyte concentration in PRP remains unclear, particularly regarding cartilage regeneration. This study aimed to compare the clinical outcomes and time to return to activity between leukocyte-poor PRP (LP-PRP) and leukocyte-rich PRP (LR-PRP) in OLT surgery.

Methods

Data from 29 patients with ≥ two year follow-up were retrospectively reviewed: 18 who received LP-PRP and 11 who received LR-PRP with OLT surgery. The study assessed the timeline of return to activity and Self-Managed Foot Evaluation Questionnaire (SAFE-Q) scores preoperatively and at three months, six months, and two years postoperatively.

Results

The LP-PRP group resumed jogging and sports significantly earlier than the LR-PRP group (P = 0.03, P < 0.01). No patients in either group experienced complications. Both groups showed improved SAFE-Q scores at six months, but at two years, the LP-PRP group maintained significantly higher scores compared to their preoperative levels, whereas the LR-PRP group showed declines in some domains.

Conclusion

LP-PRP enabled an earlier return to sports compared with LR-PRP. Additionally, LP-PRP maintained good clinical scores two years after surgery. In contrast, the LR-PRP group showed some decline from their early postoperative peak, although absolute scores remained above preoperative levels. These findings suggest that LP-PRP may be an effective adjuvant treatment for OLT surgery.

Level of evidence

III.