M Del Torto1, D Enea2, N Panfoli3, G Filardo4, N Pace3, M Chiusaroli3. 1. Department of Orthopaedics and Traumatology, Jesi Civil Hospital, Viale Della Vittoria, 76, Jesi, AN, Italy. dtmichi@libero.it. 2. Department of Orthopaedics, Polytechnic University of Marche, Ancona, Italy. 3. Department of Orthopaedics and Traumatology, Jesi Civil Hospital, Viale Della Vittoria, 76, Jesi, AN, Italy. 4. II Clinic - Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy.
Abstract
PURPOSE: Anterior cruciate ligament (ACL) rupture is the most common complete ligamentous injury in the knee. Many studies explored ACL graft integration and maturation, but only a few assessed the application of platelet rich fibrin matrix (PRFM) as augmentation for ACL reconstruction. The main aim of this study was to test the PRFM augmentation in terms of graft-bone integration and knee stability. The secondary aim was to investigate patient-reported functional status. METHODS: Prospective evaluation has been done in two consecutive series of patients who underwent ACL reconstruction with semitendinosus and gracilis (STG) grafts: 14 patients were operated with PRFM augmentation and 14 patients without PRFM augmentation. Objective clinical evaluation (Rolimeter) and MRI evaluation were performed at 1 year from surgery. Subjective evaluation (IKDC) was performed pre-operatively and at 6 months, 1 and 2 years from surgery. RESULTS: A statistically significant difference was not detected between the two groups in terms of MRI and objective clinical evaluation, although PRFM-augmented patients showed a statistically significant higher clinical improvement. CONCLUSIONS: The procedure described for PRFM augmentation in ACL STG reconstruction does not improve radiologic graft integration and knee stability after 1 year and should not be used by clinicians to this purpose. However, it may result in a short-term improvement of patient-reported knee function, and future research should focus on further developing PRP treatment to optimize ACL clinical outcome. LEVEL OF EVIDENCE: III.
PURPOSE: Anterior cruciate ligament (ACL) rupture is the most common complete ligamentous injury in the knee. Many studies explored ACL graft integration and maturation, but only a few assessed the application of platelet rich fibrin matrix (PRFM) as augmentation for ACL reconstruction. The main aim of this study was to test the PRFM augmentation in terms of graft-bone integration and knee stability. The secondary aim was to investigate patient-reported functional status. METHODS: Prospective evaluation has been done in two consecutive series of patients who underwent ACL reconstruction with semitendinosus and gracilis (STG) grafts: 14 patients were operated with PRFM augmentation and 14 patients without PRFM augmentation. Objective clinical evaluation (Rolimeter) and MRI evaluation were performed at 1 year from surgery. Subjective evaluation (IKDC) was performed pre-operatively and at 6 months, 1 and 2 years from surgery. RESULTS: A statistically significant difference was not detected between the two groups in terms of MRI and objective clinical evaluation, although PRFM-augmented patients showed a statistically significant higher clinical improvement. CONCLUSIONS: The procedure described for PRFM augmentation in ACL STG reconstruction does not improve radiologic graft integration and knee stability after 1 year and should not be used by clinicians to this purpose. However, it may result in a short-term improvement of patient-reported knee function, and future research should focus on further developing PRP treatment to optimize ACL clinical outcome. LEVEL OF EVIDENCE: III.
Authors: Martha M Murray; Kurt P Spindler; Eduardo Abreu; John A Muller; Arthur Nedder; Mark Kelly; John Frino; David Zurakowski; Maria Valenza; Brian D Snyder; Susan A Connolly Journal: J Orthop Res Date: 2007-01 Impact factor: 3.494
Authors: Mario Orrego; Catalina Larrain; Julio Rosales; Luis Valenzuela; José Matas; Juan Durruty; Hernán Sudy; Rodrigo Mardones Journal: Arthroscopy Date: 2008-09-30 Impact factor: 4.772
Authors: Adriano Marques de Almeida; Marco Kawamura Demange; Marcel Faraco Sobrado; Marcelo Bordalo Rodrigues; André Pedrinelli; Arnaldo José Hernandez Journal: Am J Sports Med Date: 2012-04-02 Impact factor: 6.202
Authors: G Filardo; E Kon; A Roffi; B Di Matteo; M L Merli; M Marcacci Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-11-26 Impact factor: 4.342
Authors: Marcus Vinicius Danieli; João Paulo Fernandes Guerreiro; Alexandre Oliveira Queiroz; Hamilton da Rosa Pereira; Daniele Cristina Cataneo Journal: Int Orthop Date: 2020-09-29 Impact factor: 3.075
Authors: Berardo Di Matteo; Markus Loibl; Luca Andriolo; Giuseppe Filardo; Johannes Zellner; Matthias Koch; Peter Angele Journal: World J Orthop Date: 2016-09-18