Fibrin clot prevents bone tunnel enlargement after ACL reconstruction with allograft

Sürer, Levent; Yapici, Can; Guglielmino, Claudia; Eck, Carola F. van; Irrgang, James J.; Fu, Freddie H.

doi:10.1007/s00167-016-4109-y

Cited by 13 publications

(9 citation statements)

References 46 publications

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“…10,11 Fibrin clots have been shown to enhance the surgical repair of tissue with poor healing capacity. [12][13][14] In 1988, Arnoczky et al 12 described the application of a fibrin clot to aid healing of meniscal defects in the avascular zone in a 1 canine model. Additional clinical studies have also shown increased healing of meniscal tears with the application of fibrin clots including complete radial tears in the avascular zone and horizontal cleavage tears.…”

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confidence: 99%

“…18 Furthermore, the addition of a fibrin clot to allograft in anterior cruciate ligament reconstruction has been shown to reduce the amount of tunnel widening at 1 year. 14 The use of platelet-rich plasma as a method to concentrate and deliver bioactive factors has been explored. 3 The platelets in platelet-rich plasma provide an increase in growth factors important for healing of compromised tissue.…”

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confidence: 99%

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Adipose Stem Cells Incorporated in Fibrin Clot Modulate Expression of Growth Factors

Siegel

Clevenger

Clegg

et al. 2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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confidence: 99%

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confidence: 99%

Adipose Stem Cells Incorporated in Fibrin Clot Modulate Expression of Growth Factors

Siegel

Clevenger

Clegg

et al. 2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…[8] The greater aperture widening was supported not only by a biomechanical study, but also by a clinical study. In a clinical study of 50 patients who underwent single-bundle ACL reconstruction with suspensory femoral fixation, Surer et al [9] showed that the tunnel widening was 0.3 to 10 mm greater in the aperture than in the midportion of the femoral tunnel regardless of using a fibrin clot. The main theory of the mechanism of the biological factor of tunnel widening was local inflammation to the localized cell necrosis of the ACL graft over time after surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the aperture and midportion femoral tunnel widening after anterior cruciate ligament reconstruction

Çelik

Lee

2019

Medicine

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Background: To identify whether the aperture or the midportion of the femoral tunnel had a larger tunnel widening in patients who undergo ACL reconstruction. Methods: PubMed, EMBASE and Cochrane Library were searched for relative studies that evaluated tunnel widening in patients underwent arthroscopic ACL reconstruction. Two reviewers independently recorded data from each study, including the sample size and magnitude of tunnel widening. Random-effects meta-analyses were performed to pool the outcomes of tunnel widening by estimating the standardized mean differences in tunnel widening and their 95% confidence intervals (CIs), Publication bias was assessed using funnel plots and Egger test when the number of included studies was >10. Results: Eleven included studies compared tunnel widening between the aperture and the midportion. In these studies, 372 and 92 patients underwent single- and double-bundle ACL reconstructions, respectively. Subgroup analyses in terms of evaluation imaging tool for tunnel widening showed no significant differences in tunnel widening between the aperture and the midportion of the femoral tunnel regardless of plain radiograph (mean difference, 0.02 mm; P = .97), computed tomography (mean difference 0.08 mm; P = .55), and magnetic resonance imaging (mean difference, 0.13 mm; P = .78). Likewise, no significant difference in femoral tunnel widening was found between the aperture and the midportion, irrespective of transtibial (mean difference, 0.18 mm; P = .57), anteromedial (mean difference, 0.02 mm; P = .90), and outside-in techniques (mean difference, 0.01 mm; P = .98). Conclusion: No significant difference in femoral tunnel widening was found between the aperture and the midportion in the patients who underwent ACL reconstruction.

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“…Surer et al divided the longitudinal axis of the bone tunnel into three equal portions. In each portion, the width of the tunnel was measured at the widest part 40 . This was done for the femoral and tibial tunnel on the AP radiograph and for the tibial tunnel only on the lateral radiograph, since the femoral tunnel is not easily identifiable on this view.…”

Section: Radiographsmentioning

confidence: 99%

“…This was done for the femoral and tibial tunnel on the AP radiograph and for the tibial tunnel only on the lateral radiograph, since the femoral tunnel is not easily identifiable on this view. The radiographs were taken immediately post-operatively, as well as at 1-year follow-up to calculate the amount of tunnel widening that had occurred 40 .…”

Section: Radiographsmentioning

confidence: 99%

How to evaluate bone tunnel widening after ACL reconstruction - a critical review

Michael

2017

MLTJ

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SummaryBackground: Comparing different imaging modalities and methods for assessment tunnel widening after ACL reconstruction and providing a detailed evidence-based literature overview. Methods: PubMed was searched from 1970 to 2016 using the terms "ACL reconstruction" and "tunnel" and "imaging" or "CT" or "computerized tomography" or "MRI" or "magnetic resonance imaging" or "radiographs". 647 studies were found. 575 articles were excluded due to absence of specific radiological measurement methods of tunnel widening and 40 due to repetition of a previously published radiological measurement method. 32 articles were included reporting interand intraobserver reliabilities of tunnel measurement methods after ACL reconstruction. Results: A variety of different algorithms and measurement methods using radiographs, magnetic resonance imaging, computed tomography or SPECT/CT evaluating tunnel position and bone tunnel enlargement have been described. Tunnel delination restricts an exact analysis using X-ray. Measurements using CT or MR were mostly obtained perpendicular to the tunnel axis or using specialized software for tunnel volume calculation in 3D. Based on the review the width of the femoral and tibial tunnels should be assessed perpendicular to the tunnel axis at different levels in relation to the joint. At least one measurement should be performed at the tunnel entrance, exit and midpoint of the tunnel. Conclusion: CT should be considered the gold standard assessing tunnel widening in patients after ACL reconstruction. If specialized software is available calculating the tunnel volume, measurements should be preferably performed in 3D CT. Level of evidence: II.

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Fibrin clot prevents bone tunnel enlargement after ACL reconstruction with allograft

Abstract: Case-control study, Level III.

Cited by 13 publications

References 46 publications

Adipose Stem Cells Incorporated in Fibrin Clot Modulate Expression of Growth Factors

Adipose Stem Cells Incorporated in Fibrin Clot Modulate Expression of Growth Factors

Comparison of the aperture and midportion femoral tunnel widening after anterior cruciate ligament reconstruction

How to evaluate bone tunnel widening after ACL reconstruction - a critical review

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