Magnetic resonance imaging evaluation of the integration and maturation of semitendinosus-gracilis graft in anterior cruciate ligament reconstruction using autologous platelet concentrate.
OBJECTIVE
To evaluate integration and maturation of semitendinosus-gracilis (STG) grafts in anterior cruciate ligament (ACL) reconstruction with magnetic resonance imaging (MRI) in patients who underwent ACL reconstruction with STG with and without autologous platelet concentrate (APC).


METHODS
A randomized single-blinded evaluator prospective study was performed in 2 consecutive series of patients who underwent reconstruction over a 14-month period: 30 with APC use (group A) and 20 as control subjects (group B). At 6 months, an MRI evaluation was performed, with observation of the graft's maturation and presence or absence of synovial fluid at the tunnel-graft interface. To facilitate interpretation, a scoring scale was designed to evaluate graft integration and maturation.


RESULTS
Regarding the presence of synovial fluid at the bone-graft interface, the test was negative in 86.84% of patients in group A and 94.74% in group B. A disorganized autograft signal pattern was found in 2.63% in group A and 5.26% in group B. Signal intensity was considered hypointense in 63.16% in group A and 42.11% in group B, isointense in 34.21% in group A and 52.63% in group B, and hyperintense in 0% in both groups. The final mean score was 4.45 points in group A and 4.2 points in group B (P ≥ .05). Poor integration was found in 2.63% in group A and 5.26% in group B (P = .214). Good integration was found in 97.37% in group A and 94.74% in group B (P = .784).


CONCLUSIONS
In our consecutive series of patients who underwent ACL reconstruction with STG grafts, 1 group with intraoperative APC use versus a control group, followed up by MRI at 6 months after reconstruction, we did not find any statistically significant benefit in the APC group in terms of integration assessment and graft maturation (ligamentization).


METHODS
Level III, case-control study.
Figueroa
David
D
Knee Surgery Unit, Orthopaedic Surgery Department, Clínica Alemana and Universidad del Desarrollo, Santiago, Chile. dfigueroa@alemana.cl
Melean
Patricio
P
Calvo
Rafael
R
Vaisman
Alex
A
Zilleruelo
Nicolás
N
Figueroa
Francisco
F
Villalón
Ignacio
I
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017847:Patellar Ligament / Q000473:pathology / Q000601:surgery / Q000637:transplantation; D017713:Platelet Transfusion; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000534:rehabilitation; D016037:Single-Blind Method; D014182:Transplantation, Autologous / Q000379:methods