title: Evaluation of the tibial tunnel after intraoperatively administered platelet-rich plasma gel during anterior cruciate ligament reconstruction using diffusion weighted and dynamic contrast-enhanced MRI.
abstract: OBJECTIVE
  To evaluate effect of platelet-rich plasma gel (PRPG), locally administered during the anterior cruciate ligament (ACL) reconstruction, with two MRI methods. The proximal tibial tunnel was assessed with diffusion weighted imaging (DWI) and with dynamic contrast-enhanced imaging (DCE-MRI).
  
  
  METHODS
  In 50 patients, standard arthroscopic ACL reconstructions were performed. The patients in the PRPG group (n = 25) received a local application of PRPG. The proximal tibial tunnel was examined by DWI and DCE-MRI, which were used to calculate apparent diffusion coefficient (ADC) values, as well as the contrast enhancement gradient (G(enh)) and enhancement factor (F(enh)) values.
  
  
  RESULTS
  At 1 month, the calculated average ADC value in the PRPG group was significantly lower than in the control group. At 2.5 and at 6 months, G(enh) was significantly higher in the PRPG group. There were no significant differences in F(enh) between the groups at any control examination.
  
  
  CONCLUSIONS
  DWI and DCE-MRI measurements indicate a reduced extent of edema during the first postoperative month as well as an increased vascular density and microvessel permeability in the proximal tibial tunnel at 1 and 2.5 postoperative months as the effect of the application of PRPG.
authors.affiliation: Radiology Department, University Medical Center Maribor, Slovenia. mitja.rupreht@guest.arnes.si
authors.forename: Mitja
authors.initials: M
authors.lastname: Rupreht
authors.forename: Vladimir
authors.initials: V
authors.lastname: Jevtič
authors.forename: Igor
authors.initials: I
authors.lastname: Serša
authors.forename: Matjaž
authors.initials: M
authors.lastname: Vogrin
authors.forename: Marko
authors.initials: M
authors.lastname: Jevšek
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D002199:Capillary Permeability / Q000502:physiology; D003287:Contrast Media / Q000008:administration & dosage*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004487:Edema / Q000175:diagnosis / Q000517:prevention & control; D005260:Female; D005782:Gels; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007593:Joint Instability / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D013977:Tibia / Q000473:pathology*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005782:Gels