Has Platelet-Rich Plasma Any Role in Anterior Cruciate Ligament Allograft Healing?
Received 10 October 2008; accepted 2 June 2009.
Purpose
The aim of this study was to evaluate and compare the clinical and inflammatory parameters with the addition of platelet-derived growth factor (PDGF) in primary anterior cruciate ligament (ACL) reconstruction with bone–patellar tendon–bone allograft.
Methods
We prospectively randomized 100 patients undergoing arthroscopic patellar tendon allograft ACL reconstruction to a group in whom platelet-enriched gel was used (n = 50) and a non-gel group (n = 50). The platelet concentration was 837 × 103/mm3, and the gel was introduced inside the graft and the tibial tunnel. Demographic data were comparable between groups. The mean follow-up was 24 months for both groups and included a history, clinical evaluation with the International Knee Documentation Committee score, radiographs, and magnetic resonance imaging.
Results
There were no differences in the number of associated injuries. The results did not show any statistically significant differences between the groups for inflammatory parameters (perimeters of the knee and C-reactive protein level), magnetic resonance imaging appearance of the graft, and clinical evaluation scores (visual analog scale, International Knee Documentation Committee, and KT-1000 arthrometer [MEDmetric, San Diego, CA]).
Conclusions
At this time, the therapeutic role of PDGF in ACL reconstruction remains unclear. The use of PDGF, on the graft and inside the tibial tunnel, in patients treated with bone–patellar tendon–bone allografts has no discernable clinical or biomechanical effect at 2 years' follow-up. More clinical studies will be needed to show the efficacy and use of these factors in daily practice in ACL reconstruction.
Level of Evidence
Level I, prospective, randomized, double-blind study.
aDepartment of Orthopaedic Surgery and Traumatology, Clínica Universitaria of Navarra, Pamplona, Spain
bDepartment of Radiology, Clínica Universitaria of Navarra, Pamplona, Spain
cDepartment of Haematology, Clínica Universitaria of Navarra, Pamplona, Spain
Address correspondence and reprint requests to Juan Ramón Valentí Nin, M.D., Ph.D., Departamento de COT, Clínica Universitaria de Navarra, Avda Pío XII 36, Pamplona CP 31008, Spain
ABSTRACT