ACL Reconstruction with Augmentation: a Scoping Review

Riediger, Michael; Stride, Devon; Coke, Sarah E.; Kurz, Adrian Z.; Duong, Andrew; Ayeni, Olufemi R.

doi:10.1007/s12178-019-09548-4

Cited by 13 publications

(14 citation statements)

References 38 publications

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“…Some applications with biological agents have been used to increase treatment effectiveness. The platelet-rich plasma (PRP) is one of the main biological agents investigated for this purpose [ 6 ]. PRP is mostly used due to its effects on the stimulation and repair of musculoskeletal injuries [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…They promote anabolic cell stimulation, increase in the deposition of the extracellular matrix, reduction in the pro-apoptotic and anti-inflammatory joint environment. It can be easily obtained, prepared, and applied during the ACL reconstruction surgery [ 6 ]. PRP can decrease tissue regeneration time which can be very beneficial especially for elite professional athletes [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Texture analysis to differentiate anterior cruciate ligament in patients after surgery with platelet-rich plasma

et al. 2021

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Background Platelet-rich plasma (PRP) has been used to favor anterior cruciate ligament (ACL) healing after reconstruction surgeries. However, clinical data are still inconclusive and subjective about PRP. Thus, we propose a quantitative method to demonstrate that PRP produced morphological structure changes. Methods Thirty-four patients undergoing ACL reconstruction surgery were evaluated and divided into control group (sixteen patients) without PRP application and experiment group (eighteen patients) with intraoperative application of PRP. Magnetic resonance imaging (MRI) scans were performed 3 months after surgery. We used Matlab® and machine learning (ML) in Orange Canvas® to texture analysis (TA) features extraction. Experienced radiologists delimited the regions of interest (RoIs) in the T2-weighted images. Sixty-two texture parameters were extracted, including gray-level co-occurrence matrix and gray level run length. We used the algorithms logistic regression (LR), naive Bayes (NB), and stochastic gradient descent (SGD). Results The accuracy of the classification with NB, LR, and SGD was 83.3%, 75%, 75%, respectively. For the area under the curve, NB, LR, and SGD presented values of 91.7%, 94.4%, 75%, respectively. In clinical evaluations, the groups show similar responses in terms of improvement in pain and increase in the IKDC index (International Knee Documentation Committee) and Lysholm score indices differing only in the assessment of flexion, which presents a significant difference for the group treated with PRP. Conclusions Here, we demonstrated quantitatively that patients who received PRP presented texture changes when compared to the control group. Thus, our findings suggest that PRP interferes with morphological parameters of the ACL. Trial registration Protocol no. CAAE 56164316.6.0000.5411.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Texture analysis to differentiate anterior cruciate ligament in patients after surgery with platelet-rich plasma

et al. 2021

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“…Although the benefits of PRP application during ACLR have not been confirmed for many outcomes in the reconstructed ligament, the effects of PRP on pain and knee function are significant. 6 Systematic reviews examining PRP treatment for ligament and tendon injuries 14 have pointed to a positive effect in healing and pain, although this is not a universal finding. 4 Likely, this misinterpretation of previous findings resulted from the fact that PRP-related pain reduction is higher the sooner it is measured after ACLR, as confirmed by our analyses.…”

Section: Discussionmentioning

confidence: 99%

Time-Dependent Effect of Platelet-Rich Plasma in Reducing Donor-Site Pain After Anterior Cruciate Ligament Reconstruction

et al. 2020

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Background: Anterior cruciate ligament reconstruction (ACLR) has a high incidence among sports players, and one important side effect of the surgery is graft donor site morbidity. Although some evidence suggests that application of platelet-rich plasma (PRP) during ACLR reduces pain and improves knee function, it is not a universal finding. Purpose: To perform a meta-analysis of previous studies testing the effects of PRP on donor site morbidity after ACLR. Study Design: Systematic review and meta-analysis. Methods: We reviewed PubMed (Medline), Web of Science, Embase, Scopus, and Cochrane databases to find studies testing the effects of PRP on the donor site of ACLR autograft. After identifying 4 studies, we conducted 2 meta-analyses, 1 for the effects of PRP on pain, assessed by visual analog scale (VAS), and the other for the functional knee scores. We also tested the ability of time after ACLR to predict the PRP-related reduction of pain. Results: In the 4 studies identified, 157 patients were analyzed. Although the VAS score was lower with PRP at 6 months (raw mean difference [RMD], –0.97 [95% CI, −1.59 to −0.36]; P = .001) and 12 months (RMD, −0.61 [95% CI,−1.02 to −0.21]; P = .003), the effects of PRP disappeared at 24 months (RMD, −0.08 [95% CI,−0.38 to 0.22]; P = .586). A univariate regression analysis reinforced the ability of time after ACLR to predict the PRP-related reduction of VAS pain score ( r2 = 0.98). However, knee function after ACLR was not improved by the use of PRP (standardized mean difference, 0.71 [95% CI,−0.17 to 1.60]; P = .114). Conclusion: PRP applied to a bone–patellar tendon–bone donor site could reduce knee pain within a year, and this reduction had a correlation with time, meaning that the effect of PRP decreased with time after surgery. However, pain reduction did not reach clinical relevance and did not lead to better functional knee scores.

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“…Biological evidence such as osseointegration of the graft-tunnel interface and intra-articular molecular bonding indicates beneficial effects when considering graft maturation. 17 Ventura et al performed a systematic review of the current literature on the use of PRP in ACL reconstruction and found 11 articles initially demonstrating an increase in intra-articular component remodeling of the graft during the first 10 years of follow-up. 18 Among these, one study showed an improvement in the integration.…”

Section: Prp For Acl Augmentationmentioning

confidence: 99%

Biologic Acl Repair Augmentation

Fernandes

Barbosa

et al. 2023

Bio Orthop J

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The incidence of anterior cruciate ligament (ACL) injuries is on the rise due to increased physical and sports activities. Thus, ACL reconstruction is a common surgical procedure to treat ACL ruptures, however, it has a failure rate of 0.7–21% and only 63% of the patients are able to recover to their pre-injury sport level. Orthobiologics, including platelet-rich plasma (PRP), growth factors, and stem cells, are being explored as alternative treatment methods to maximize the results and reduce surgical morbidity and healing time. PRP is derived from a blood sample with high platelet concentration and containing growth factors and interleukins. Studies have shown that PRP can improve the maturation of ACL reconstruction but more research is required to support its use in ACL surgery. On one hand, growth factors play a crucial role in ligament healing and PRP, which contains high levels of growth factors, has been shown to stimulate angiogenesis and encourage cell proliferation. On the other hand, stem cells have the ability to differentiate into other cell types and limit the inflammatory microenvironment during acute ligament injury. Ligament-derived stem cells show better potential for lineage-specific tendon/ligament differentiation when used with differentiation inducers. The use of stem cells in ACL reconstruction is still in the early stages of investigation. Therefore, cell therapy agents have shown promising results in preclinical models, but more research is required to determine the most effective biological agents for treatment.

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ACL Reconstruction with Augmentation: a Scoping Review

Cited by 13 publications

References 38 publications

Texture analysis to differentiate anterior cruciate ligament in patients after surgery with platelet-rich plasma

Texture analysis to differentiate anterior cruciate ligament in patients after surgery with platelet-rich plasma

Time-Dependent Effect of Platelet-Rich Plasma in Reducing Donor-Site Pain After Anterior Cruciate Ligament Reconstruction

Biologic Acl Repair Augmentation

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