Effects of Platelet-Rich Plasma on Tendon-Bone Healing After Anterior Cruciate Ligament Reconstruction

Orthop Surg. 2022 Jan;14(1):88-95. doi: 10.1111/os.13175. Epub 2021 Dec 6.

Abstract

Objective: To investigate the effect of platelet-rich plasma on tendon-bone healing after anterior cruciate ligament reconstruction.

Methods: This retrospective study included 85 patients (range, 18-50 years; mean age, 33.95 ± 10.53 years; male/female, 49/36) who underwent anterior cruciate ligament reconstruction using autologous hamstring tendons between August 2017 and June 2019 at our institute. The participants in the study group (n = 42) were injected with platelet-rich plasma at both ends of the tendon graft, while those in the control group (n = 43) received an injection of normal saline. Magnetic resonance imaging signal/noise quotient values of the femoral and tibial ends, knee Lysholm scores, and International Knee Documentation Committee scores were compared at 3, 6, and 12 months postoperatively.

Results: The signal/noise quotient values of the femoral and tibial ends in both groups were higher at 6 months than at 3 and 12 months postoperatively. The signal/noise quotient values of the tibial end were significantly lower in the platelet-rich plasma group than in the normal saline group at all follow-up time points (P < 0.05). The signal/noise quotient values of the tibial and femoral ends in both groups were significantly different at 3, 6, and 12 months postoperatively (P < 0.05). Additionally, the signal/noise quotient values of the tibia were significantly lower than those of the femur in both groups (P < 0.05). The Lysholm and International Knee Documentation Committee scores were significantly better in the platelet-rich plasma group than in the normal saline group only at 3 months postoperatively. No complications, such as knee joint infection or vascular and nerve injuries, occurred in any of the 85 patients. The knee flexion of all patients were more than 90°, and the straight degree was 0°. No joint stiffness was observed in all patients.

Conclusion: Platelet-rich plasma can promote tendon-bone healing in grafts and can improve early postoperative knee joint function.

Keywords: Anterior cruciate ligament reconstruction; Magnetic resonance imaging; Platelet-rich plasma; Signal/noise quotient; Tendon-bone healing.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Female
  • Hamstring Tendons / transplantation*
  • Humans
  • Male
  • Middle Aged
  • Platelet-Rich Plasma*
  • Retrospective Studies
  • Transplantation, Autologous
  • Wound Healing*
  • Young Adult