Platelet-rich plasma: does it help reduce tunnel widening after ACL reconstruction?
- 743 Downloads
The purpose of this study was to evaluate the efficacy of platelet-rich plasma (PRP) in reducing femoral and tibial tunnel enlargement in patients operated on for anterior cruciate ligament reconstruction with hamstrings.
Forty male patients, in which both femoral and tibial 9-mm tunnels were performed because of the graft size, were enrolled in this prospective study. They were randomly assigned to group A (20 patients, PRP group) and group B (20 patients, control group). All patients were followed up at a median of 14.7 months (range 10–16 months), with a physical examination, the Tegner, Lysholm and objective IKDC scoring scales, and with the KT-1000 arthrometer. Moreover, they underwent a CT evaluation in order to assess the amount of tunnel enlargement.
Femoral tunnel diameter increased from 9.0 ± 0.1 mm to 9.8 ± 0.3 mm in group A (p = 0.032) and from 9.0 ± 0.1 mm to 9.4 ± 0.5 mm in group B (p = 0.043). Tibial tunnel diameter increased from 9.0 ± 0.2 mm to 10.9 ± 0.2 mm in group A (p = 0.029) and from 9.1 ± 0.1 mm to 10.1 ± 0.4 mm in group B (p = 0.028). Physical examination as well as the evaluation scales used showed no differences between the two groups.
The use of PRP does not seem to be effective in preventing tunnel enlargement.
Level of evidence
Therapeutic study, Level II.
KeywordsPlatelet-rich plasma Tunnel enlargement ACL reconstruction CT scan
- 1.Brown CH, Ferretti A, Conteduca F et al (2001) Biomechanics of the Swing-Bridge technique for anterior cruciate ligament reconstruction. Eur J Sports Traum Rel Res 23(2):69–73Google Scholar
- 3.Cervellin M, de Girolamo L, Bait C et al (2012) Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study. Knee Surg Sports Traumatol Arthrosc 20(1):114–120PubMedCrossRefGoogle Scholar
- 5.Clatworthy MG, Bartelett J, Howell S et al (1999) The effect of graft fixation techniques on tunnel widening in hamstring ACL reconstruction. Arthroscopy 15(Suppl):5Google Scholar
- 19.Hogervorst T, Van der Hart CP, Pels Rijcken TH et al (2000) Abnormal bone scans of the tibial tunnel 2 years after patella ligament anterior cruciate ligament reconstruction: correlation with tunnel enlargement and tibial graft length. Knee Surg Sports Traumatol Arthrosc 8(6):322–328PubMedCrossRefGoogle Scholar
- 27.Marchant MH Jr, Willimon SC, Vinson E et al (2010) Comparison of plain radiography, computed tomography, and magnetic resonance imaging in the evaluation of bone tunnel widening after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18(8):1059–1064PubMedCrossRefGoogle Scholar
- 53.Yu JK, Paessler HH (2005) Relationship between tunnel widening and different rehabilitation procedure after cruciate ligament reconstruction with quadrupled hamstring tendons. Chin Med J (Engl) 118(4):320–326Google Scholar