Objective: To investigate the effect of platelet-rich plasma on tendon-bone healing after anterior cruciate ligament reconstruction.Methods: This retrospective study included 85 patients (range, 18-50 years; mean age, 33.95 AE 10.53 years; male/female, 49/36) who underwent anterior cruciate ligament reconstruction using autologous hamstring tendons between August 2017 and June 2019 at our institute. The participants in the study group (n = 42) were injected with platelet-rich plasma at both ends of the tendon graft, while those in the control group (n = 43) received an injection of normal saline. Magnetic resonance imaging signal/noise quotient values of the femoral and tibial ends, knee Lysholm scores, and International Knee Documentation Committee scores were compared at 3, 6, and 12 months postoperatively. Results:The signal/noise quotient values of the femoral and tibial ends in both groups were higher at 6 months than at 3 and 12 months postoperatively. The signal/noise quotient values of the tibial end were significantly lower in the platelet-rich plasma group than in the normal saline group at all follow-up time points (P < 0.05). The signal/noise quotient values of the tibial and femoral ends in both groups were significantly different at 3, 6, and 12 months postoperatively (P < 0.05). Additionally, the signal/noise quotient values of the tibia were significantly lower than those of the femur in both groups (P < 0.05). The Lysholm and International Knee Documentation Committee scores were significantly better in the platelet-rich plasma group than in the normal saline group only at 3 months postoperatively. No complications, such as knee joint infection or vascular and nerve injuries, occurred in any of the 85 patients. The knee flexion of all patients were more than 90 , and the straight degree was 0 . No joint stiffness was observed in all patients. Conclusion:Platelet-rich plasma can promote tendon-bone healing in grafts and can improve early postoperative knee joint function.
Purpose:To investigate whether single femoral, single tibial tunnel anatomic double-bundle anterior cruciate ligament (ACL) reconstruction is equal to or superior to double femoral, double tibial tunnel ACL double-bundle anatomic reconstruction in terms of restoring the stability and functions of the knee joint.Methods:A prospective clinical study was performed to compare 30 cases of single-tunnel ACL double-bundle anatomic reconstruction to 28 cases of double-tunnel ACL double-bundle anatomic reconstruction, with average follow-up of 36 months. All graft tendons were hamstring tendon autografts. Tunnel placements in all the cases were made anatomically. Clinical results were collected after reconstruction. Graft appearance, meniscus status and cartilage state under arthroscopy were compared and analyzed.Results:Tunnel placements were in the anatomic positions in both groups. On the lateral pivot-shift test performed at 36 months postoperatively, there was no significant difference between groups. Clinical results such as International Knee Documentation Committee score, Tegner activity scale, and range of motion showed no significant differences between the groups. The mean thickness of anteromedial graft was reduced by 10.3% and that of the posterolateral graft was reduced by 11.1% from the original graft thickness evaluated by magnetic resonance imaging. No new meniscal tears were found either group; however, cartilage damage occurred in the double-tunnel group at 39.3%, and this rate was significantly higher than that in the single-tunnel group (10.0%).Conclusion:Single femoral, single tibial tunnel anatomic double-bundle ACL reconstruction has the same effectiveness as the double femoral, double tibial tunnel in restoring the knee's stability and functions.
BACKGROUND: The relationship between the signal/noise quotient value and knee function scores has not been extensively studied. Thus, we aimed to investigate the correlation between graft maturity and knee function after anterior cruciate ligament reconstruction.METHODS: In this retrospective study, we included patients (n=50; 28 male patients; age, 31.0 years) who underwent anterior cruciate ligament reconstruction with autogenous tendons between August 2016 and August 2018. At 6 months and 2 years postoperatively, the signal/noise quotient values of the tibia and femur, indicating graft maturity, were measured using magnetic resonance imaging. The Tegner, Lysholm, and International Knee Documentation Committee scores were used to evaluate knee function. Mean signal/noise quotient values of the grafts’ femoral and tibial ends were considered the final signal/noise quotient values. The correlation between the signal/noise quotient value at 6 months postoperatively and knee function score at 2 years postoperatively was analyzed. RESULTS: All patients were followed up for 24–28 months. The International Knee Documentation Committee, Lysholm, and Tegner scores of the knee joint at 6 months and 2 years postoperatively were significantly higher than the preoperative scores, and those at 2 years postoperatively were significantly higher than those at 6 months postoperatively. The signal/noise quotient value for all patients at 6 months postoperatively was negatively correlated with the Lysholm, International Knee Documentation Committee, and Tegner scores at 2 years postoperatively.CONCLUSION: The signal/noise quotient value based on magnetic resonance imaging in the early stage after anterior cruciate ligament reconstruction can predict knee function in the later stage.
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