A study to compare the functional outcome of anterior cruciate ligament reconstruction using autologous tendon graft with or without platelet rich plasma augmentation
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20254210Keywords:
Anterior cruciate ligament, IKDC score, Lysholm score, Platelet rich plasma, SNQ valueAbstract
Background: Reconstructing the anterior cruciate ligament (ACL) poses significant challenges, particularly in achieving secure attachment between the tendon and bone. Bone integration within the bone tunnel determines the outcome, influenced by graft type and fixation method. Platelet rich plasma (PRP) may enhance the ligamentization process of the graft, facilitating improved incorporation within bone tunnels. This synergistic approach could mitigate tunnel enlargement and graft failure over time.
Methods: A prospective comparative study (August 2023-June 2024) involved 80 patients (18-45 years) with acute complete ACL tears. Patients were divided into two groups: Group A (n=40) received 6 ml PRP injection during arthroscopic ACL reconstruction, while Group B (n=40) underwent surgery without PRP. Follow-ups occurred at 6 weeks, 3 months, and 6 months
Results: At 6 months, PRP group's SNQ values indicated improved tendon-bone healing. Lysholm scores showed significant improvements at 3 (14.49%) and 6 months (10.67%) (p<0.05). IKDC scores demonstrated similar trends, with significant differences at 3 (12.67%) and 6 months (7.08%) (p<0.05).
Conclusions: The use of PRP improved Lysholm score, IKDC score and SNQ value to certain extent but we did not find any statistically significant benefit in the PRP group.
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References
Ellison AE, Berg EE. Embryology, anatomy and function of the anterior cruciate ligament. Orthop Clin North Am. 1985;16:3–14. DOI: https://doi.org/10.1016/S0030-5898(20)30463-6
Fruensgaard S, Johannsen HV. Incomplete ruptures of the anterior cruciate ligament. J Bone Joint Surg Br. 1989;71(3):526-30. DOI: https://doi.org/10.1302/0301-620X.71B3.2722951
Fu FH, Bennett CH, Lattermann C, Ma CB. Current trends in anterior cruciate ligament reconstruction. The American J Sports Med. 1999;27(6):821-30. DOI: https://doi.org/10.1177/03635465990270062501
Yuan T, Zhang C Q, Wang J H. Augmenting tendon and ligament repair with platelet- rich plasma (PRP). Muscle Ligaments Tendons J. 2013;3(3):139-49. DOI: https://doi.org/10.32098/mltj.03.2013.05
Vogrin M, Rupreht M, Dinevski D. Effects of a platelet gel on early graft revascularization after anterior cruciate ligament reconstruction: A prospective, randomized, double-blind, clinical trial. Eur Surg Res. 2010;45:77-85. DOI: https://doi.org/10.1159/000318597
Scheffler SU, Unterhauser FN, Weiler A. Graft remodelling and ligamentization after cruciate ligament reconstruction. Knee Surg Traumatol Arthrosc. 2008;16:834–42. DOI: https://doi.org/10.1007/s00167-008-0560-8
Vogrin M, Rupreht M, Crnjac A, Dinevski D, Krajnc Z, Recnik G. The effect of platelet- derived growth factors on knee stability after anterior cruciate ligament reconstruction: A prospective randomized clinical study. Wien Klin Wochenschr. 2010;122:91-5. DOI: https://doi.org/10.1007/s00508-010-1340-2
Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43-9. DOI: https://doi.org/10.1097/00003086-198509000-00007
Figueroa D, Melean P, Calvo R. Magnetic resonance imaging evaluation of the integration and maturation of semitendinosus-gracilis graft in anterior cruciate ligament reconstruction using autologous platelet concentrate. Arthrosc. 2010;26:1318-25. DOI: https://doi.org/10.1016/j.arthro.2010.02.010
Girgis FG, Marshall JL, Al Monajem ARS. The cruciate ligaments of the knee joint. Clinic Orthop. 1975;106:216–31. DOI: https://doi.org/10.1097/00003086-197501000-00033