Introduction
To evaluate clinical,functional and arthrometric outcomes as well as integration and maturation of STG grafts with Magnetic Resonance Imaging (MRI) in Anterior Cruciate Ligament reconstruction in two groups of patients that underwent ACL reconstruction with and without the use of Autologous Platelet Concentrate(APC) Hypothesis: The use of APC in ACL reconstruction could improve the maturation and the integration of the grafts.
Methods
A randomized single blinded evaluator prospective study was performed, two consecutive series of patients reconstructed in 14 months period; 30 with APC use (A) and 20 as control (B). At 6 months Lysholm, IKDC scores,Isokinetic and arthrometric parameters and an MRI evaluation was performed, observing the graft's maturation and presence or absence of synovial fluid in bone tunnel-graft interface. To facilitate interpretation a scoring scale was designed to evaluate graft integration and maturation ANOVA and Chi square test were performed
Results
There was no statistical difference between Lysholm, IKDC scores and Isokinetic and KT 1000 test. Presence of synovial fluid in bone graft interface: Negative: A 86.84%, B 94.74%. Average scores: A 1.9, B 1.96 points (p=0.720). Autograft signal pattern: Disorganized: A 2.63%, B 5.26%. Hypointense: A 63.16%, B 42.11%. Isointense: A 34.21%, B 52.63%. Hyperintense: 0% in both groups. Average scores: A 2.58, B 2.32 points (p=0.316). Final average scores: A 4.45, B 4.2 points (p≥0.05). Poor integration: A 2.63%, B 5.26% (p=0.214). Good integration: A 97.37%, B 94.74% (p=0.784).
Conclusion
No significant differences were found between groups related to clinical, functional or arthrometric outcomes. No differences were found when observing graft's signal pattern. A trend to more positives was found when evaluating the presence of synovial fluid in group A which could mean less integration. A trend to a more hypointense graft signal was also found in this group; this could be interpreted as better ligamentization.
Article info
Identification
Copyright
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
