Value of platelet-rich plasma in osteointegration of tendon graft in anterior cruciate ligament reconstruction

الملخص EN

One of the challenges of anterior cruciate ligament (ACL) reconstruction is to achieve secure graft attachment between the tendon and bone to allow early range of motion and activity and allowing an earlier return to unrestricted activity.

Aim of study: to evaluate the role of Platelet Rich Plasma (PRP) in tendon-to-bone integration in the ACL reconstruction at (12 + weeks) post-operative follow-up by clinical, biomechanical & magnetic resonance (MR) imaging.

Patients and methods: A prospective randomized comparative study was done at Orthopedic Department of Basra General Hospital between June 2014 and October 2015.

A twenty seven patients, male, active, young, were divided into two groups; 13 patients ACL reconstructions without PRP and 14 patients ACL reconstructions with PRP injection.

Both groups were subjected to the same surgeon, same post-operative rehabilitation program, and same radiologist.

The clinical (lysholum knee scaling score) results, (good and excellent score) were 8 (57.2 %) (P.value = 0.066).

The stability tests results (anterior drawer test grade1) were 12(85.7%) (P.value=0.000).

Lachman test grade 1 was 12(85.7%) (P.value = 0.033), Pivot shift test grade 0 were 12 (85.7 %) (P.value = 0.014).

MRI findings showing signal intensity of fibrous interzone of femoral tunnel on PDW-Fat Sat images Grade 0 (4)28.6 %, (P.value = 0.057) and on T1W Fat Sat-Gad images Grade 0 (2)14.3 % (p.value 0.067).

But the range of knee motion arc for control group was best than those with PRP group (p.value < 0.05) Post-operative thigh girth difference in both groups was not significant (p.value < 0.05).

Post-operative complications as pain, swelling seem to be more in PRP group than control group.

These results were comparable to many other studies.

In conclusion: Platelet rich plasma (PRP) is a safe procedure that has beneficial effects in enhancement of graft-bone integration at 12 + weeks postoperative follow up.