The Role of Growth Factors in the Human Organism and Their Use in Medicine, Especially in Orthopedics and Traumatology

Frei, Remus; Biosca, F E; Handl, Markus Johannes; T, Trč

doi:10.55095/achot2008/045

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…Doba návratu do plné sportovní záteže od okamžiku operace je však u každého pacienta individuál ní (6). Mezi faktory ovlivňující dobrý výsledek ACLR patří zejména správné načasování výkonu, optimální výběr operační techniky a její precizní technické provede ní včetně způsobu přípravy štěpu, spolupráce pacienta, adekvátní rehabilitace a v neposlední řadě i biologické faktory ovlivňující vhojování a ligamentizaci štěpu (7,9,19). Právě interpersonálně odlišné hojivé schopnosti pacientů významně ovliňují rychlost i kvalitu ligamentizace a maturace štěpu LCA (18).…”

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Evaluation of the MRI Findings on a Tendon Graft after the Anatomic Anterior Cruciate Ligament Reconstruction in Patients with Versus without the Application of Platelet-Rich Fibrin - Results of the Prospective Randomised Study

Zeman¹,

Kasl²,

Tupý³

et al. 2018

Acta Chir. orthop. Traum. Cech.

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PURPOSE OF THE STUDYThe purpose of the prospective randomised study was to assess the benefits of the platelet-rich fibrin (PRF) application during the anatomic anterior cruciate ligament reconstruction (ACLR) for tendon graft healing. MATERIAL AND METHODSThe study included 40 patients with an isolated rupture of the anterior cruciate ligament in the knee. The MRI findings on the tendon graft were evaluated at 6 months and 12 months after the surgery in a total of 33 patients, namely in 10 women/23 men (21 right knee/12 left knee), with the mean age of 29.1 years and at the mean follow-up of 15.9 weeks after the injury. The randomisation using envelopes was carried out at the beginning of arthroscopy either in the group with the PRF application (Group 1) (17 patients) or in the group without the PRF application (Group 2) (16 patients). The followed-up patients underwent the ACLR with targeting the femoral tunnel through anteromedial portal using the autografts of m. semitendinosus and m. gracilis with Tightrope femoral fixation and Inion implant in tibia. In Group 1, during the surgery PRF was applied both in the drilled tunnels (intraosseously) and directly to the surface of the tendon graft itself (intraarticular part). The Group 2 was a control group in which the same intervention was performed, however without the PRF application. In the 6 th and 12 th month after the surgery, the signal intensity of the knee and occurrence of the ACL graft failure, bone (marrow) oedema rate near the tunnels were assessed by an independent radiologist using a 3 Tesla MRI. RESULTSIn the 6 th and also in the 12 th postoperative month, neither a complete, nor a partial graft failure was found in the group with PRF, whereas in Group 2 a complete or a partial graft failure was observed in 12.5% (p = 0.23). In the 6 th month, a bone marrow oedema near the intraosseous parts of the graft was reported in 94.1% of patients in Group 1 and in 81.3% of patients in Group 2, while in the 12 th month it was 23.5% of evaluated patients in Group 1 and 37.5% patients in Group 2. The differences between the two groups were not statistically significant in the 6 th (p = 0.096) or in the 12 th month (p = 0.43). In the 6 th month, a fully ligamentised graft was found in 52.9% of patients in Group 1 and in 37.5% of patients in Group 2 (p = 0.061), a partially ligamentised graft was present in 47.1% of patients in Group 1 and in 50% of patients in Group 2. In the 12 th month, a fully ligamentised graft was seen in 94.1% of patients in Group 1 and in 75% of patients in Group 2 (p = 0.26) and a partially ligamentised graft was present in 5.9% of patients in Group 1 and in 12.5% of patients in Group 2. In the remaining 12.5% of patients in Group 2, the finding was assessed as a graft with no signs of ligamentisation. DISCUSSIONWe have not encountered a paper in the Czech or world literature which would present results of a similar study, i.e. which would evaluate the potential benefits of the platelet-rich fibrin application in the course of the anatom...

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Evaluation of the MRI Findings on a Tendon Graft after the Anatomic Anterior Cruciate Ligament Reconstruction in Patients with Versus without the Application of Platelet-Rich Fibrin - Results of the Prospective Randomised Study

Zeman¹,

Kasl²,

Tupý³

et al. 2018

Acta Chir. orthop. Traum. Cech.

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“…PRP je nyní široce využívaná metoda k léčbě mnoha měkkotkáňových lézí pohybového aparátu. Krevní destičky obsahují mnoho druhů růstových faktorů, které pozitivně ovlivňují hojivou reakci hostitele v místě poranění nebo degenerace a usnadňují tak reparaci a přestavbu tkáně (4).…”

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The Effect of Platelet-Rich Plasma on Graft Healing in Reconstruction of the Anterior Cruciate Ligament of the Knee Joint: Prospective Study

Komzák¹,

Hart²,

Šmíd³

et al. 2015

Acta Chir. orthop. Traum. Cech.

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PURPOSE OF THE STUDYGrowth factors produced by platelets enhance tissue healing. The aim of this study was to confirm or disprove the hypothesis that, in anterior cruciate ligament (ACL) reconstruction, the application of platelet-rich plasma (PRP) into the tibial and femoral tunnels and in the graft enhances graft maturation and graft-bone interface healing and thus improves knee function at 3 and 12 months post-operatively in comparison with the control group. MATERIAL AND METHODSA total of 40 patient had the surgery; 20 underwent single-bundle hamstring reconstruction with PRP application (PRP group) and 20 had the same surgery without PRP addition (control group). A 5 ml amount of PRP was obtained from the patient's peripheral blood. A graft inserted in the bone tunnels was fixed with interference screws and, after intra-articular fluid aspiration, 1 ml of PRP was injected into each tunnel and 3 ml were evenly applied to the intra-articular portion of the graft. The patients were examined by MRI at 3 and 12 months after surgery. The subsidence of swelling in the tunnelsurrounding tissues was taken as a sign of graft-bone interface healing, and increased signal intensity of the graft was considered as a result of its ligamentisation. The knee functional status was evaluated at 3 and 12 post-operative months, using the scoring systems (Cincinnati score, IKDC score). RESULTSBone swelling was found at 3 post-operative months in 18 of 20 patients in both the PRP and the control group. Graft signal intensity was increased in most patients (19 of the PRP group; 18 control patients; p = 0.949). The Cincinnati score at 3 months had an average value of 72.7 (34-100; SO, 18.7) in the PRP group and 73.4 (42-99; SO, 16.3) in the control group (p = 0.793).The functional score after 12 months improved to 97.5 (75-100; SO, 12.8) in the PRP group and to 95.1 (66-100; SO, 13.1) in the control group; there was no significant difference between the groups (p = 0.885) at either 3 or 12 months. The IKDC score showed similar results.At 12 months bone swelling was recorded in seven out of 20 patients in the PRP group and in nine patients in the control group (p = 0.751). Graft signal intensity was increased in three and four patients of the PRP and control groups, respectively (p = 0.681). There was a statistical difference between the findings at 3 and 12 months within each group, but no difference between the groups. DISCUSSIONIn ACL reconstruction, the process of tendon graft-to-bone healing has several stages involving inflammation, cell proliferation and graft ligamentisation. At each stage, an important role is played by growth factors produced by thrombocytes, and therefore their potential use in the treatment of injuries to ligaments and tendons has recently come into focus. A number of experimental studies dealing with the effect of platelet-rich plasma on soft tissue healing has been published. Therefore, the method of using PRP to enhance graft healing in ACL reconstruction in humans is still being studied. CONSLUSIONSThe...

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Platelet-rich plasma in patients with tibiofemoral cartilage degeneration

Hart

Safi

Komzák

et al. 2013

Arch Orthop Trauma Surg

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The Role of Growth Factors in the Human Organism and Their Use in Medicine, Especially in Orthopedics and Traumatology

Cited by 9 publications

References 17 publications

Evaluation of the MRI Findings on a Tendon Graft after the Anatomic Anterior Cruciate Ligament Reconstruction in Patients with Versus without the Application of Platelet-Rich Fibrin - Results of the Prospective Randomised Study

Evaluation of the MRI Findings on a Tendon Graft after the Anatomic Anterior Cruciate Ligament Reconstruction in Patients with Versus without the Application of Platelet-Rich Fibrin - Results of the Prospective Randomised Study

The Effect of Platelet-Rich Plasma on Graft Healing in Reconstruction of the Anterior Cruciate Ligament of the Knee Joint: Prospective Study

Platelet-rich plasma in patients with tibiofemoral cartilage degeneration

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