Anatomic ACL reconstruction: does the platelet-rich plasma accelerate tendon healing?
Recently, the use of hamstring tendons in anterior cruciate ligament repair has been increasing. However, tendon-to-bone healing occurs slowly, which can be a problem to an early return to sport activities. The use of growth factors from platelets seems to improve tissue healing. We enrolled 40 patients in a prospective study that were submitted to an anatomic reconstruction of the anterior cruciate ligament. Patients were sequentially enrolled into four groups: group A without platelet-rich plasma (PRP); group B with PRP in femoral tunnels at the end of surgery; group C with PRP in femoral tunnels at the end of surgery and intra-articular at 2- and 4 weeks after surgery; group D with PRP activated with thrombin in the femoral tunnels. All patients underwent magnetic resonance imaging of the knee 3 months after surgery to evaluate the signal intensity of the fibrous interzone (FIZ) in the femoral tunnels. We did not find any difference among the groups when comparing the signal intensity of the FIZ on magnetic resonance imaging.
KeywordsAnterior cruciate ligament Anatomic reconstruction Platelet-rich plasma Prospective randomized study
- 5.Breitfuss H, Frohlich R, Povacz P et al (1996) The tendon defect after ACL reconstruction using the mid third patellar tendon: a problem for the patellofemoral joint? Knee Surg Sports Traumatol Arthrosc 24:196–198Google Scholar
- 12.May D, Disler D, Jones E, Balkissoon A, Manaster B. (2000) Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. 20:S295–S315Google Scholar
- 13.Murray MM, Palmer M, Abreu E, Spindler KP, Zurakowski D, Fleming BC (2008) Platelet-rich plasma alone is not sufficient to enhance suture repair of the ACL in skeletally immature animals: an in vivo study (2008) J Orthop Res [Epub ahead of print]Google Scholar
- 19.Raghoebar GM et al (2005) Does platelet-rich plasma promote remodelling of autologous bone grafts used for the augmentation of the maxillary sinus floor? Clin Oral Implants Res16:359–356Google Scholar
- 22.Rosenberg J, Deffner K (1997) ACL reconstruction: semitendinosus tendon is the graft of choice. Orthopaedics 20:396–398Google Scholar
- 23.Rubin D (2007) Magnetic resonance imaging: techniques and protocols tendons. In: Resnick (ed) Internal derangement of joints, 2nd edn. Saunders, Philadelphia, pp 40–41Google Scholar
- 24.Sampaio R et al (1995) Tumores dos Tecidos Moles em RM: correlação do hipossinal em T2 com as características microscópicas [MR imaging of Soft-Tissue Tumors: correlation of hipointensity in T2WI with histologic features]. Acta Radiol Portuguesa 8:23–28Google Scholar
- 25.Sharpey W, Ellis GV (1856) Elements of anatomy, vol 1, 6th edn. Walton and Moberly, LondonGoogle Scholar
- 31.Weiler A, Sckeffler S, Apreleva M (2006) Healing of ligaments and tendon to bone. In: Walsh W (ed) Repair and regeneration of ligaments, tendons, and joint capsule, 1st edn. Humana Press, New Jersey, pp 201–231Google Scholar
- 32.Welsh WJ (2000) Autologous platelet gel-clinical function and usage in plastic surgery. Cosmetic Derm 13:13–18Google Scholar
- 33.Woo SL-Y, Suh J-K, Parsons IM et al (1998) Biologic intervention in ligament healing Sports. Med Arthrosc Rev 6:74–82Google Scholar