Original Article
Comparison of Magnetic Resonance Imaging Findings in Anterior Cruciate Ligament Grafts With and Without Autologous Platelet-Derived Growth Factors

Presented at the Biannual Meeting of the Sociedad Latinoamericana de Artroscopia Rodilla y Traumatología Deportiva, Cancún, Mexico, June 5-7, 2008.
https://doi.org/10.1016/j.arthro.2009.06.030Get rights and content

Purpose

To determine whether the use of platelet-rich plasma gel (PRPG) affects magnetic resonance imaging (MRI) findings in the anterior cruciate ligament (ACL) graft during the first year after reconstruction.

Methods

A prospective single-blinded study of 50 ACL reconstructions in 50 patients was performed. In group A (study group) PRPG was added to the graft with a standardized technique, and in group B (control group) no PRPG was added. An MRI study was performed postoperatively between 3 and 9 months in group A and between 3 and 12 months in group B. The imaging analysis was performed in a blind protocol by the same radiologist.

Results

The mean heterogeneity score value at the time of MRI, assigned by the radiologist, was 1.14 in group A and 3.25 in group B. Both groups were comparable in terms of sex and age (P < .05). The mean time to obtain a completely homogeneous intra-articular segment in group A (PRPG added) was 177 days after surgery, and it was 369 days in group B. Using the quadratic predictive model, these findings show that group A (PRPG added) needed only 48% of the time group B required to achieve the same MRI image (P < .001).

Conclusions

ACL reconstruction with the use of PRPG achieves complete homogeneous grafts assessed by MRI, in 179 days compared with 369 days for ACL reconstruction without PRPG. This represents a time shortening of 48% with respect to ACL reconstruction without PRPG.

Level of Evidence

Level III, case-control study.

Section snippets

Study Design

This is a prospective and single-blinded study performed between June 2005 and December 2006. The inclusion criteria were sport athletes of both gender between 18 and 35 years old with an isolated ACL tear shown by MRI. Exclusion criteria were previous ACL revision surgery, chronic or systemic disease under treatment, and previous or current treatment for malignant disease. These pathologies can modify the biologic behavior of the graft. Fifty consecutive patients met the inclusion criteria.

The

Results

The mean heterogeneity score value at the time of MRI, assigned by the radiologist, was 1.14 in group A and 3.25 in group B. Both groups were comparable in terms of sex and age (P < .05). The mean time to obtain a completely homogeneous intra-articular segment in group A (PRPG added) was 177 days after surgery, and it was 369 days in group B. Using the quadratic predictive model, the percentage of time that group A (PRPG added) needed to achieve the same MRI aspect as group B was 48% (Fig 6).

Discussion

For elite athletes, recovery from ACL injury must reach a level close to normal and occur in the shortest time possible so as not to affect the future athletic performance. In the last decade great advances have occurred in ACL reconstruction surgery, considerably improving the outcomes. This is because of the development of more anatomic reconstruction techniques, stronger and more stable methods of attachment over time, accelerated rehabilitation protocols, better technical training, and

Conclusions

ACL reconstruction with the use of PRPG achieves completely homogeneous grafts, assessed by MRI, in 179 days compared with 369 days for ACL reconstruction without PRPG. This represents a time shortening of 48% with respect to ACL reconstruction without PRPG.

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    The authors report no conflict of interest.

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