scholarly journals PRP Augmentation for ACL Reconstruction

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Luca Andriolo ◽  
Berardo Di Matteo ◽  
Elizaveta Kon ◽  
Giuseppe Filardo ◽  
Giulia Venieri ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Reconstructive Surgery ◽  
Platelet Rich Plasma ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Functional Results ◽  
Tendon Graft ◽  
Safe Procedure ◽  
Patellar Tendon Graft ◽  
Beneficial Effects

Current research is investigating new methods to enhance tissue healing to speed up recovery time and decrease the risk of failure in Anterior Cruciate Ligament (ACL) reconstructive surgery. Biological augmentation is one of the most exploited strategies, in particular the application of Platelet Rich Plasma (PRP). Aim of the present paper is to systematically review all the preclinical and clinical papers dealing with the application of PRP as a biological enhancer during ACL reconstructive surgery. Thirty-two studies were included in the present review. The analysis of the preclinical evidence revealed that PRP was able to improve the healing potential of the tendinous graft both in terms of histological and biomechanical performance. Looking at the available clinical evidence, results were not univocal. PRP administration proved to be a safe procedure and there were some evidences that it could favor the donor site healing in case of ACL reconstruction with patellar tendon graft and positively contribute to graft maturation over time, whereas the majority of the papers did not show beneficial effects in terms of bony tunnels/graft area integration. Furthermore, PRP augmentation did not provide superior functional results at short term evaluation.

Patellar Bone–Tendon–Bone Autografts versus Quadriceps Tendon Allograft with Synthetic Augmentation in a Canine Model

2019 ◽  
Vol 33 (12) ◽  
pp. 1256-1266 ◽  
Author(s):  
Patrick A. Smith ◽  
James P. Stannard ◽  
Chantelle C. Bozynski ◽  
Keiichi Kuroki ◽  
Cristi R. Cook ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Platelet Rich Plasma ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Quadriceps Tendon ◽  
Canine Model ◽  
Tendon Graft ◽  
Donor Site Morbidity ◽  
Tendon Allograft ◽  
Internal Brace

AbstractPatellar bone–tendon–bone (pBTB) autografts are often considered the “gold standard” for complete anterior cruciate ligament (ACL) reconstruction and are also associated with significant complications and early-onset knee osteoarthritis (OA). A novel quadriceps tendon allograft with synthetic augmentation, or “internal brace” (QTIB), has been reported to have potential advantages for ACL reconstruction based on animal model data. In this preclinical canine comparison study, we hypothesized that QTIB allograft compared with pBTB autograft would provide superior durability for knee stability, function, and prevention of OA. Under approval from our Institutional Animal Care and Use Committee, adult purpose-bred research hounds (n = 10) underwent arthroscopic complete transection of the ACL followed by either an arthroscopic-assisted all-inside ACL reconstruction using the QTIB allograft (n = 5) or pBTB autograft (n = 5). Contralateral knees were used as nonoperated controls (n = 10). Radiographic and arthroscopic assessments were performed at 2 and 6 months, respectively, after surgery. Anterior drawer, internal rotation, lameness, kinetics, pain, effusion, and comfortable range of knee motion were measured at 2, 3, and 6 months. Biomechanical and histologic assessments were performed at 6 months. All reconstructed knees were stable and had intact ACL grafts 6 months after surgery. At 6 months, QTIB reconstructed knees had significantly less lameness, lower pain, less effusion, and increased range of motion when compared with BTB knees (p < 0.05). BTB knees had significantly higher radiographic OA scores than QTIB knees at 6 months (p < 0.05). Superior outcomes associated with QTIB allograft may be due to the lack of donor site morbidity, the use of a robust tendon graft, and/or protection of the graft from the synthetic augmentation. Robust tendon grafts combined with a synthetic internal brace and platelet-rich plasma (PRP) may allow for more rapid and robust tendon–bone healing and graft “ligamentization,” which protects the graft from early failure and rapid OA development that can plague commonly-used allografts.

COMPARATIVE STUDY OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE GRAFT AND HAMSTRING GRAFT

2019 ◽  
pp. 1-5
Author(s):  
Shivananda S. ◽  
Nikhil Das ◽  
Anudeep. N. Naik ◽  
Jai Aditya Jhamb* ◽  
Anil K Nair
Keyword(s):  
Bone Graft ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Statistical Significance ◽  
Medical Science ◽  
Tendon Graft ◽  
Hamstring Graft ◽  
Patellar Tendon Graft ◽  
Bone Patellar Tendon

INTRODUCTION: ACL reconstruction is probably the most common procedure of the knee in adults in recent times, and the choice of graft to be used for it is the most important decision to be made during the surgery.Although several methods of ACL reconstruction exist,the 2 most common procedures done are BTB reconstruction using an autograft of the middle third of the patellar tendon and reconstruction using a (HT) graft. PURPOSE: The purpose of this study was to evaluate the midterm functional outcome of ACL reconstruction using the bone-patellar tendon-bone graft and hamstring graft. MATERIALS AND METHODS: The study was conducted in the Department of Orthopaedics,Kempegowda institute of medical science and research centre.A total of 40 cases were operated out of whom 20 were operated using arthroscopic ACL reconstruction using Hamstring graft and other 20 underwent ACLR using Patellar tendon graft.Patients in our study were assessed by IKDC,Tegners and Lysholm operative scores. RESULTS- The mean age of the patients in our study was around 29 years. Around 70% of our patients were operated within 6 months from the time of injury after achieving complete flexion. Evaluation using IKDC, Lyshom and tegner scoring system showed hamstring graft having statistical significance when compared with BPTB graft, but the difference between the groups was not clinically appreciable. CONCLUSIONS: ACL reconstruction by either hamstring tendon graft or bone patellar tendon graft gives equally satisfactory results.But complications in the form of anterior knee pain were noted in BPTB group

Effect of Graft Choice on Revision and Contralateral Anterior Cruciate Ligament Reconstruction: Results From the New Zealand ACL Registry

2019 ◽  
Vol 48 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Richard Rahardja ◽  
Mark Zhu ◽  
Hamish Love ◽  
Mark G. Clatworthy ◽  
Andrew Paul Monk ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Hamstring Tendon Graft ◽  
Patellar Tendon Graft ◽  
Increased Risk ◽  
Graft Rupture ◽  
Anterior Cruciate

Background: The patellar tendon is often considered the “gold standard” graft for reducing the risk of graft rupture after anterior cruciate ligament (ACL) reconstruction. However, its use may also be associated with an increased risk of injury to the contralateral ACL. Purpose: To clarify the association between graft choice and the risk of revision and contralateral ACL reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: Prospective data captured by the New Zealand ACL Registry between April 2014 and December 2018 were reviewed. All primary ACL reconstructions performed using either a hamstring tendon or patellar tendon autograft were included. Cox regression survival analysis adjusting for patient factors was performed to compare the risk of revision and contralateral ACL reconstruction between the hamstring tendon graft and the patellar tendon graft. Results: A total of 7155 primary ACL reconstructions were reviewed, of which 5563 (77.7%) were performed using a hamstring tendon graft and 1592 (22.3%) were performed using a patellar tendon graft. Patients with a hamstring tendon graft had a revision rate of 2.7% compared with 1.3% in patients with a patellar tendon graft (adjusted hazard ratio [HR], 2.51; 95% CI, 1.55-4.06; P < .001). The patellar tendon graft was associated with an increased risk of contralateral ACL reconstruction compared with the hamstring tendon graft (adjusted HR, 1.91; 95% CI, 1.15-3.16; P = .012). The number needed to treat (NNT) with a patellar tendon graft to prevent 1 revision was 73.6. However, the NNT with a hamstring tendon graft to prevent 1 contralateral reconstruction was 116.3. Conclusion: Use of a patellar tendon graft reduced the risk of graft rupture but was associated with an increased risk of injury to the contralateral ACL. Adequate rehabilitation and informed decision making on return to activity and injury prevention measures may be important in preventing subsequent injury to the healthy knee.

scholarly journals Bioresorbable Stent in Anterior Cruciate Ligament Reconstruction

Polymers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1961
Author(s):  
Krzysztof Ficek ◽  
Jolanta Rajca ◽  
Mateusz Stolarz ◽  
Ewa Stodolak-Zych ◽  
Jarosław Wieczorek ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Healing Process ◽  
Tendon Graft ◽  
Bone Tunnel ◽  
Control Group ◽  
Microstructural Parameters ◽  
Beneficial Effects ◽  
Anterior Cruciate

The exact causes of failure of anterior cruciate ligament (ACL) reconstruction are still unknown. A key to successful ACL reconstruction is the prevention of bone tunnel enlargement (BTE). In this study, a new strategy to improve the outcome of ACL reconstruction was analyzed using a bioresorbable polylactide (PLA) stent as a catalyst for the healing process. The study included 24 sheep with 12 months of age. The animals were randomized to the PLA group (n = 16) and control group (n = 8), subjected to the ACL reconstruction with and without the implantation of the PLA tube, respectively. The sheep were sacrificed 6 or 12 weeks post-procedure, and their knee joints were evaluated by X-ray microcomputed tomography with a 50 μm resolution. While the analysis of tibial and femoral tunnel diameters and volumes demonstrated the presence of BTE in both groups, the enlargement was less evident in the PLA group. Also, the microstructural parameters of the bone adjacent to the tunnels tended to be better in the PLA group. This suggested that the implantation of a bioresorbable PLA tube might facilitate osteointegration of the tendon graft after the ACL reconstruction. The beneficial effects of the stent were likely associated with osteogenic and osteoconductive properties of polylactide.

scholarly journals Arthroscopic anterior cruciate ligament reconstruction with semitendinosus graft versus peroneus longus tendon graft

2020 ◽  
Vol 6 (2) ◽  
pp. 386
Author(s):  
Pudari Manoj Kumar ◽  
Ishan Shevte ◽  
Mukesh Phalak ◽  
Abhishek Nair ◽  
Parth .
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Tendon Graft ◽  
Collateral Ligament ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Cruciate ◽  
Tendon Autograft

<p class="abstract"><strong>Background:</strong> Arthroscopic anterior cruciate ligament (ACL) reconstruction can be performed using autograft from various sources namely, bone patellar tendon graft, hamstring tendons (semitendinosus, gracilis) or peroneus longus tendon.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 30 patients who underwent arthroscopic ACL reconstruction using quadrupled semitendinosus tendon autograft and peroneus longus tendon autograft during the study period.<strong></strong></p><p class="abstract"><strong>Results:</strong> Statistically, there is very little comparable difference between semitendinosus and peroneus longus when used for arthroscopic ACL reconstruction. However, peroneus longus tendon shows superior results when used in patients with grade 3 medial collateral ligament (MCL) injury combined with ACL injury.</p><p class="abstract"><strong>Conclusions:</strong> Our study brings forth the superior efficacy and quality of the double stranded peroneus longus tendon especially in cases associated with complicated injuries involving the medial collateral ligament with a follow up date of about 2 years and as a healthy supplement to other choices of autografts and revision cases.</p>

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