{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:54:34Z","timestamp":1790949274495,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T00:00:00Z","timestamp":1625529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Posttraumatic osteoarthritis (PTOA) significantly affects patients with pilon fractures even after adequate anatomical reduction, and treatment strategies targeting the biologic mediators of PTOA are needed. This study was designed to determine the effects of intra\u2010articular injection of platelet\u2010rich plasma (PRP) on synovial fluid (SF) biomarkers for patients undergoing open reduction and internal fixation (ORIF) of pilon fractures. Patients undergoing staged management of pilon fractures were enrolled in a prospective, double\u2010blinded, randomized, and placebo\u2010controlled clinical trial to determine the effects of a single intra\u2010articular injection of leukocyte\u2010reduced PRP on SF biomarkers. Arthrocentesis of the injured and uninjured ankles was performed at the time of external skeletal fixation (ESF) and ORIF. Patients were randomized to receive either autogenous leukocyte\u2010reduced PRP or saline (control) via intra\u2010articular injection into the injured ankle at the time of ESF. SF biomarker concentrations were compared\u2014uninjured, injured pretreatment, and saline\u2010injected or PRP\u2010injected. Eleven patients (PRP, <jats:italic>n<\/jats:italic>\u2009=\u20095; saline, <jats:italic>n<\/jats:italic>\u2009=\u20096) completed the study. Twenty\u2010one uninjured, and 11 injured pretreatment, five PRP\u2010treated, and six saline\u2010treated SF samples were analyzed. PRP\u2010treated SF contained significantly higher levels of PDGF\u2010AA (<jats:italic>p<\/jats:italic>\u2009=\u20090.046) and significantly lower levels of MMP\u20103 (<jats:italic>p<\/jats:italic>\u2009=\u20090.042), MMP\u20109 (<jats:italic>p<\/jats:italic>\u2009=\u20090.009), IL\u20101\u03b2 (<jats:italic>p<\/jats:italic>\u2009=\u20090.049), IL\u20106 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), IL\u20108 (<jats:italic>p<\/jats:italic>\u2009=\u20090.048), and PGE2 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.04). This study provided mechanistic data to suggest that a single intraarticular injection of leukocyte\u2010reduced PRP is associated with anti\u2010inflammatory, anti\u2010degradative, and anabolic responses compared with saline control. These findings provide the impetus for investigating long\u2010term clinical outcomes after PRP injection as an orthobiologic adjunct to ORIF for mitigating the incidence and severity of PTOA after pilon fractures.<\/jats:p>","DOI":"10.1002\/jor.25123","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T13:08:59Z","timestamp":1624972139000},"page":"925-932","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["A prospective randomized double\u2010blind clinical trial to assess the effects of leukocyte\u2010reduced platelet\u2010rich plasma on pro\u2010inflammatory, degradative, and anabolic biomarkers after closed pilon fractures"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3349-7717","authenticated-orcid":false,"given":"Bradford P.","family":"Zitsch","sequence":"first","affiliation":[{"name":"School of Medicine University of Missouri  Columbia 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