MRI EVALUATION OF BIOLOGICALLY ENHANCED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Abstract

Platelet-rich plasma (PRP) and anterior cruciate ligament (ACL) residual remnant preservation are used today as biologic therapies aimed at stimulating graft healing process after ACL reconstruction, but their synergism has not been established yet. The aim of our study was to investigate the combined influence of PRP and ACL remnant preservation on graft healing after ACL reconstruction and evaluate the results with MRI. Material and methods: The study included 52 patients (45 men and 7 women, mean age 28) divided into 2 groups: group I (control group)-28 patients in whom after the removal of ACL residual bundle, a standard single bundle ACL reconstruction was made, and group II (examined group)-24 patients in whom remnant preserving ACL reconstruction with addition of PRP was performed. The results were assessed 6 months after surgery by MRI evaluation of the graft healing process. Results: Patients in the examined group had more frequently a light hyperintense signal of the intra-articular part of the graft (75% vs. 35.7%, p=0.0046) and absence of synovial fluid at tunnel-graft interface (45.8% vs. 21.4%, p=0.06), average 0.98 cm 2 less surface of bone edema around the graft (p=0.009) than those from the control group. Conclusion: Combined use of PRP and ACL remnant preservation has a positive influence on graft healing after ACL reconstruction leading to faster ligamentization and osteoligamentous integration of the graft.