Platelet‐rich plasma alone is not sufficient to enhance suture repair of the ACL in skeletally immature animals: An in vivo study

Abstract

In this study, we hypothesize that supplementation of suture repair of the anterior cruciate ligament (ACL) with platelet-rich plasma (PRP) will improve the biomechanics of the repair. Six 30-kg pigs underwent bilateral suture repair of the ACL. One side was treated with suture repair alone, while the contralateral side was treated with suture repair augmented with PRP. After 14 weeks in vivo, anteriorposterior (AP) knee laxity and the tensile properties of the repaired ligament were measured. The addition of PRP to the suture repairs did not improve AP knee laxity at 308 (p ¼ 0.73) or 608 (p ¼ 0.65). It also did not improve the maximum tensile load (p ¼ 0.64) or linear stiffness (p ¼ 0.42) of the ACL repairs after 14 weeks in vivo. The model had 80% power to detect a 30% improvement of biomechanical properties with PRP; thus, we are confident that a clinically meaningful effect as a result of adding PRP is unlikely. Use of PRP alone to supplement suture repair of the ACL is ineffective in this animal model. ß

The Effect of Skeletal Maturity on Functional Healing of the Anterior Cruciate Ligament

“…The soft tissues surrounding the tibia and femur were removed, leaving the capsule intact, and the knees were potted as previously described so that they could be secured within a materials testing system [11][12][13] . All mechanical testing evaluators were blinded as to treatment group and age during the testing process.…”

“…From the load-displacement curves, the following structural properties were established: yield load, failure load, linear stiffness, and displacement to 5 N (low-load displacement). Yield, displacement, and maximum displacement were determined as previously described 12 . Identical testing was performed for the knees with intact anterior cruciate ligaments in each age group.…”

2011 AOA Symposium: Tissue Engineering and Tissue Regeneration

“…Using this model, we found that placement of a collagen-platelet scaffold in the wound site of the ACL could stimulate both histologic and biomechanical healing of the ligament 76 and that, by three months, the strength of the ACL treated with a bio-enhanced repair technique was similar to that previously reported for ACL reconstruction in similar animal models 77 . Interestingly enough, when either a collagen scaffold alone 78 or a platelet solution alone 79 was used as the bio-enhancement, there was no statistically significant improvement over suture repair alone.…”

Evaluation of bone tunnel placement for suture augmentation of an injured anterior cruciate ligament: Effects on joint stability in a goat model

“…[7][8][9][10] Thus, there exists a need to develop better approaches to treat ACL injuries. Recently, there has been clinical interest 11,12 and numerous laboratory studies using functional tissue engineering [13][14][15][16][17] to promote healing of an injured ACL. Nevertheless, healing following these new biological approaches has been slow, and suture repair and/or augmentation of the torn ends of the ACL is recommended to achieve initial knee stability and limit loss of function and damage to other tissues, including the medial collateral ligament, medial meniscus, and articular cartilage.…”

“…Nevertheless, healing following these new biological approaches has been slow, and suture repair and/or augmentation of the torn ends of the ACL is recommended to achieve initial knee stability and limit loss of function and damage to other tissues, including the medial collateral ligament, medial meniscus, and articular cartilage. [18][19][20][21][22][23][24] A plethora of procedures exist for suture repair and suture augmentation. 17,20,[25][26][27][28] In repair, the torn ACL ends are either sutured to each other or sutured separately and tensioned by passing the sutures through bone tunnels drilled in the tibia and femur and fixing them against the bone.…”