Has platelet-rich plasma any role in anterior cruciate ligament allograft healing?
OBJECTIVE
The aim of this study was to evaluate and compare the clinical and inflammatory parameters with the addition of platelet-derived growth factor (PDGF) in primary anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone allograft.


METHODS
We prospectively randomized 100 patients undergoing arthroscopic patellar tendon allograft ACL reconstruction to a group in whom platelet-enriched gel was used (n = 50) and a non-gel group (n = 50). The platelet concentration was 837 x 10(3)/mm(3), and the gel was introduced inside the graft and the tibial tunnel. Demographic data were comparable between groups. The mean follow-up was 24 months for both groups and included a history, clinical evaluation with the International Knee Documentation Committee score, radiographs, and magnetic resonance imaging.


RESULTS
There were no differences in the number of associated injuries. The results did not show any statistically significant differences between the groups for inflammatory parameters (perimeters of the knee and C-reactive protein level), magnetic resonance imaging appearance of the graft, and clinical evaluation scores (visual analog scale, International Knee Documentation Committee, and KT-1000 arthrometer [MEDmetric, San Diego, CA]).


CONCLUSIONS
At this time, the therapeutic role of PDGF in ACL reconstruction remains unclear. The use of PDGF, on the graft and inside the tibial tunnel, in patients treated with bone-patellar tendon-bone allografts has no discernable clinical or biomechanical effect at 2 years' follow-up. More clinical studies will be needed to show the efficacy and use of these factors in daily practice in ACL reconstruction.


METHODS
Level I, prospective, randomized, double-blind study.
Nin
Juan Ramón Valentí
JR
Departments of Orthopaedic Surgery and Traumatology, Clínica Universitaria of Navarra, Pamplona, Spain. avalenti@unav.es
Gasque
Gonzalo Mora
GM
Azcárate
Andrés Valentí
AV
Beola
Jesús Dámaso Aquerreta
JD
Gonzalez
Milagros Hernandez
MH
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000187:drug effects* / Q000503:physiopathology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D016025:Bone Transplantation; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D017847:Patellar Ligament / Q000637:transplantation; D010982:Platelet-Derived Growth Factor / Q000008:administration & dosage*; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D014184:Transplantation, Homologous; D014945:Wound Healing / Q000187:drug effects*; D055815:Young Adult
D010982:Platelet-Derived Growth Factor