Purpose
To determine whether the use of platelet-rich plasma gel (PRPG) affects magnetic resonance
imaging (MRI) findings in the anterior cruciate ligament (ACL) graft during the first
year after reconstruction.
Methods
A prospective single-blinded study of 50 ACL reconstructions in 50 patients was performed.
In group A (study group) PRPG was added to the graft with a standardized technique,
and in group B (control group) no PRPG was added. An MRI study was performed postoperatively
between 3 and 9 months in group A and between 3 and 12 months in group B. The imaging
analysis was performed in a blind protocol by the same radiologist.
Results
The mean heterogeneity score value at the time of MRI, assigned by the radiologist,
was 1.14 in group A and 3.25 in group B. Both groups were comparable in terms of sex
and age (P < .05). The mean time to obtain a completely homogeneous intra-articular segment
in group A (PRPG added) was 177 days after surgery, and it was 369 days in group B.
Using the quadratic predictive model, these findings show that group A (PRPG added)
needed only 48% of the time group B required to achieve the same MRI image (P < .001).
Conclusions
ACL reconstruction with the use of PRPG achieves complete homogeneous grafts assessed
by MRI, in 179 days compared with 369 days for ACL reconstruction without PRPG. This
represents a time shortening of 48% with respect to ACL reconstruction without PRPG.
Level of Evidence
Level III, case-control study.
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References
- Anterior cruciate ligament replacement using patellar tendon: An evaluation of graft revascularization in the dog.J Bone Joint Surg Am. 1982; 64: 217-224
- Revascularization and ligamentization of autogenous anterior cruciate ligament grafts in humans.Arthroscopy. 1998; 14: 197-205
- Early histologic, metabolic, and vascular assessment of anterior cruciate ligament autografts.J Orthop Res. 1989; 7: 235-242
- Light and electron microscopic study of remodeling and maturation process in autogenous graft for anterior cruciate ligament reconstruction.Arthroscopy. 1993; 9: 394-405
- Comparison between magnetic resonance imaging findings and knee stability: Measurements after anterior cruciate ligament repair with and without augmentation.Am J Sports Med. 1996; 23: 729-735
- Serial magnetic resonance imaging of hamstring anterior cruciate ligament autografts during the first year of implantation.Am J Sports Med. 1991; 19: 42-47
- Evaluation of arthroscopic anterior cruciate ligament reconstruction using magnetic resonance imaging.Am J Sports Med. 1993; 21: 523-527
- Early histologic appearance of human patellar tendon autografts used for anterior cruciate ligament reconstruction.Knee Surg Sports Traumatol Arthrosc. 1999; 7: 9-14
- Endoligamentous revascularization of an anterior cruciate ligament graft.Clin Orthop Relat Res. 2003; : 276-288
- Temporal changes in relationships between fibroblast repopulation, VEGF expression, and angiogenesis in the patellar tendon graft after ACL reconstruction.Trans Orthop Res Soc. 2003; 29: 236
- Arthroscopic, histologic and MRI correlation in the maturation process of the graft in ACL reconstruction in humans.Arthroscopy. 1998; 14 (Abstracts presented at the First Biennial Congress of ISAKOS): S20
- Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging.Am J Sports Med. 2001; 29: 751-761
- The effects of platelet-derived growth factor-BB on healing of the rabbit medial collateral ligament.Am J Sports Med. 1998; 26: 549-554
- Augmentation of tendon healing in an intra-articular bone tunnel with use of a bone growth factor.Am J Sports Med. 2001; 29: 689-698
- Effect of transforming growth factor-beta and growth differentiation factor-5 on proliferation and matrix production by human bone marrow stromal cells cultured on braided poly lactic-coglycolic acid scaffolds for ligament tissue engineering.Tissue Eng. 2007; 13: 1573-1582
- Effects of administration of exogenous growth factors on biomechanical properties of the elongation-type anterior cruciate ligament injury with partial laceration.Am J Sports Med. 2005; 33: 188-196
- Synergistic effect of growth factors on cell outgrowth from explants of rabbit anterior cruciate and medial collateral ligaments.J Orthop Res. 1995; 13: 435-441
- The effect of combinations of growth factors on ligament healing.Clin Orthop Relat Res. 1994; : 207-212
- Effects of growth factors on matrix synthesis by ligament fibroblasts.J Orthop Res. 1997; 15: 18-23
- Collagen-platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament.J Orthop Res. 2007; 25: 81-91
- Platelet-derived growth factor and transforming growth factor–β enhance tissue repair activities by unique mechanisms.J Cell Biol. 2000; 109: 429-440
- Comparison of surgically repaired achilles tendon tears using platelet-rich fibrin matrices.Am J Sports Med. 2007; 35: 245-251
- Application in arthroscopic surgery of autologous plasma rich in growth factors.Cuad Artrosc. 2003; 10 (in Spanish): 12-19
- Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture.J Orthop Res. 2005; 23: 281-286
- Timing of administration of transforming growth factor–beta and epidermal growth factor influences the effect on material properties of the in situ frozen-thawed anterior cruciate ligament.J Biomech. 2003; 36: 373-381
- Effects of combined administration of transforming growth factor-beta 1 and epidermal growth factor on properties of the in situ frozen ACL in rabbits.J Orthop Res. 2002; 20: 1345-1351
- The influence of locally applied platelet-derived growth factor–BB on free tendon graft remodeling after anterior cruciate ligament reconstruction.Am J Sports Med. 2004; 32: 881-891
- The effect of growth factors on biomechanical properties of the bone–patellar tendon–bone graft after anterior cruciate ligament reconstruction: A canine model study.Am J Sports Med. 2004; 32: 870-880
- The effect of transforming growth factor-1 on intraosseous healing of flexor tendon autograft replacement of ACL in dogs.Arthroscopy. 2005; 21: 1034-1041
- Strategies to improve anterior cruciate ligament healing and graft placement.Am J Sports Med. 2008; 36: 176-189
- Effects of platelet concentrate and bone plug on the healing of hamstring tendons in bone tunnel.Arthroscopy. 2008; 24: 1373-1380
- Can platelet-rich plasma enhance tendon repair?.Am J Sports Med. 2008; 36: 1171-1178
- Application of platelet-derived growth factors in ACL reconstruction.NotiSLARD. 2007; 2: 7-8
- Preparation of the graft in ACL reconstruction, applying platelet-derived growth factors.November 2005
- Effects of local administration of vascular endothelial growth factor on properties of the in situ frozen thawed anterior cruciate ligament in rabbits.Am J Sports Med. 2006; 34: 84-91
- Effects of local administration of vascular endothelial growth factor on mechanical characteristics of the semitendinosus tendon graft after anterior cruciate ligament reconstruction in sheep.Am J Sports Med. 2006; 36: 1918-1925
Article info
Publication history
Accepted:
June 30,
2009
Received:
August 24,
2008
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
