The Potentially Positive Role of PRPs in Preventing Femoral Tunnel Widening in ACL Reconstruction Surgery Using Hamstrings: A Clinical Study in 51 Patients

Starantzis, Konstantinos; Mastrokalos, Dimitrios S.; Koulalis, Dimitrios; Papakonstantinou, Olympia; Soucacos, P.N.; Papagelopoulos, Panayiotis J.

doi:10.1155/2014/789317

Cited by 15 publications

(48 citation statements)

References 55 publications

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“…The issue of prevention of bony tunnels enlargement was addressed in six trials, all of which were RCTs[ 22 , 25 , 28 - 31 ]. Only in two of them[ 22 , 28 ] it was demonstrated that PRP, injected locally into the tunnels[ 28 ] or intra-articularly[ 22 ], could prevent their enlargement over time. Conversely, four papers revealed no significant difference with regard to this specific outcome between treatment groups.…”

Section: Resultsmentioning

confidence: 99%

Biologic agents for anterior cruciate ligament healing: A systematic review

Matteo¹,

Loibl²,

Andriolo³

et al. 2016

WJO

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AIMTo systematically review the currently available literature concerning the application of biologic agents such as platelet-rich plasma (PRP) and stem cells to promote anterior cruciate ligament (ACL) healing.METHODSA systematic review of the literature was performed on the use of biologic agents (i.e., PRP or stem cells) to favor ACL healing during reconstruction or repair. The following inclusion criteria for relevant articles were used: Clinical reports of any level of evidence, written in English language, on the use of PRP or stem cells during ACL reconstruction/repair. Exclusion criteria were articles written in other languages, reviews, or studies analyzing other applications of PRP/stem cells in knee surgery not related to promoting ACL healing.RESULTSThe database search identified 394 records that were screened. A total of 23 studies were included in the final analysis: In one paper stem cells were applied for ACL healing, in one paper there was a concomitant application of PRP and stem cells, whereas in the remaining 21 papers PRP was used. Based on the ACL injury pattern, two papers investigated biologic agents in ACL partial tears whereas 21 papers in ACL reconstruction. Looking at the quality of the available literature, 17 out of 21 studies dealing with ACL reconstruction were randomized controlled trials. Both studies on ACL repair were case series.CONCLUSIONThere is a paucity of clinical trials investigating the role of stem cells in promoting ACL healing both in case of partial and complete tears. The role of PRP is still controversial and the only advantage emerging from the literature is related to a better graft maturation over time, without documenting beneficial effects in terms of clinical outcome, bone-graft integration and prevention of bony tunnel enlargement.

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Section: Resultsmentioning

confidence: 99%

Biologic agents for anterior cruciate ligament healing: A systematic review

Matteo¹,

Loibl²,

Andriolo³

et al. 2016

WJO

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show abstract

“…Three studies showed no significant differences [38,42,43] in functional outcomes, one study did not report functional outcome results [42], and one study reported worse outcomes in both groups when compared to baseline [32]. Six studies reported the outcomes of anterior tibial translation assessments [34,38,[41][42][43][44] with no significant differences between groups (p = 0.18) in meta-analysis. Only one study showed a significant difference in favor of PRP using KT-1000 ( Figure 8) [41].…”

Section: Anterior Cruciate Ligament Reconstruction (Acl)mentioning

confidence: 95%

“…Sixteen RCTs, including 740 patients, evaluated the use of PRP as an adjunct to ACL reconstruction with patellar ligament (Bone-Patella Tendon-Bone-BPTB) autograft [29][30][31][32][33][34][35] or hamstrings graft [33,[36][37][38][39][40][41][42][43][44] (Table 6).…”

Section: Anterior Cruciate Ligament Reconstruction (Acl)mentioning

confidence: 99%

“…Six studies reported the outcomes of anterior tibial translation assessments [34,38,[41][42][43][44] with no significant differences between groups (p = 0.18) in meta-analysis. Only one study showed a significant difference in favor of PRP using KT-1000 ( Figure 8) [41].…”

Section: Anterior Cruciate Ligament Reconstruction (Acl)mentioning

confidence: 99%

“…Five studies reported the outcome of tunnel widening after graft fixation, two of them used computer tomography (CT) [43,44] and three used MRI [39,41,42] to evaluate tunnel enlargement. The pooled estimates for four studies included in meta-analyses showed non-significant differences in favor of the control (p = 0.54) ( Figure 8).…”

Section: Anterior Cruciate Ligament Reconstruction (Acl)mentioning

confidence: 99%

See 2 more Smart Citations

The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery—A Systematic Review and Meta-Analysis

Tramś

Kulinski

Kozar-Kamińska

et al. 2020

Life

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In recent years, the interest in biological treatment of knee lesions has increased, especially the application of platelet-rich plasma is of particular note. The number of articles evaluating platelet-rich plasma (PRP) efficacy in the recovery of knee disorders and during knee surgery has exponentially increased over the last decade. A systematic review with meta-analyses was performed by assessing selected studies of local PRP injections to the knee joint. The study was completed in accordance with 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A multistep search of PubMed, Embase, Cochrane Database of Systematic Reviews, and Clinicaltrials.gov was performed to identify studies on knee surgery and knee lesion treatment with PRP. Of the 4004 articles initially identified, 357 articles focusing on knee lesions were selected and, consequently, only 83 clinical trials were analyzed using the revised Cochrane risk-of-bias tool to evaluate risk. In total, seven areas of meta-analysis reported a positive effect of PRP. Among them, 10 sub-analyses demonstrated significant differences in favor of PRP when compared to the control groups (p < 0.05). This study showed the positive effects of PRP, both on the recovery of knee disorders and during knee surgery; however further prospective and randomized studies with a higher number of subjects and with lower biases are needed.

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Biologic agents to optimize outcomes following ACL repair and reconstruction: A systematic review of clinical evidence

Kon

Matteo

Altomare

et al. 2021

Journal Orthopaedic Research

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Treatment options for anterior cruciate ligament (ACL) injuries have greatly developed over the past decades. Although reconstruction surgery is a concrete reality, stimulation of ACL healing through biological techniques could represent a revolutionary conservative approach. The use of biologic products, such as plateletrich plasma (PRP) or mesenchymal stem cells (MSCs), to treat partial ruptures or to enhance ligamentization after reconstruction, could thoroughly improve clinical outcomes. The aim of the present paper is to systematically review the available literature on this topic, to (i) describe the current state of the art in available biologic techniques; (ii) clarify the outcomes of their application; (iii) identify areas needing further investigation and possible future development. A systematic review of the literature on the use of biologically active agents (PRP and MSCs) to enhance outcomes of ACL surgery was performed: 31 studies were included. Based on the ACL injury pattern, 6 papers investigated biologic agents in ACL partial tears whereas 25 papers in ACL reconstruction. Sixteen of twenty-five studies dealing with ACL reconstruction were randomized controlled trials, whereas only case series are available for partial ACL tears. Current evidence is still lacking sound data to support the use of biological agents: no clinical superiority has been described when using PRP in ACL reconstruction. Concerning ACL healing in partial tears, the application of PRP has led to encouraging outcomes, but these findings should be confirmed by appropriately designed RCTs.

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The Potentially Positive Role of PRPs in Preventing Femoral Tunnel Widening in ACL Reconstruction Surgery Using Hamstrings: A Clinical Study in 51 Patients

Cited by 15 publications

References 55 publications

Biologic agents for anterior cruciate ligament healing: A systematic review

Biologic agents for anterior cruciate ligament healing: A systematic review

The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery—A Systematic Review and Meta-Analysis

Biologic agents to optimize outcomes following ACL repair and reconstruction: A systematic review of clinical evidence

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