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Arch Orthop Trauma Surg. 2018 May;138(5):675-683. doi: 10.1007/s00402-018-2885-1. Epub 2018 Jan 30.

Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures.

Author information

1
Department of Trauma Surgery, University Medical Centre Regensburg, Franz Josef Strauss Allee 11, 93042, Regensburg, Germany.
2
Center for Biological and Functional Reconstruction of the Knee, Humanitas Research and University Hospital, Rozzano, Italy.
3
Sporthopaedicum Straubing, Regensburg, Hildegard von Bingen Strasse 1, 93053, Regensburg, Germany.
4
Department of Trauma Surgery, University Medical Centre Regensburg, Franz Josef Strauss Allee 11, 93042, Regensburg, Germany. peter.angele@ukr.de.
5
Sporthopaedicum Straubing, Regensburg, Hildegard von Bingen Strasse 1, 93053, Regensburg, Germany. peter.angele@ukr.de.

Abstract

INTRODUCTION:

Conservative treatment of partial ACL ruptures is associated with a high failure rate, and often patients undergo ACL reconstruction. ACL preservation by trephination of the ACL origin and application of Autologous Conditioned Plasma (ACP) seems to be an intriguing new treatment option to favour ACL tissue healing and avoid traditional reconstruction. The aim of this study was to describe the mid-term outcomes of this new ACL preserving technique.

MATERIALS AND METHODS:

Twenty-four patients (mean age 41.8 years) affected by partial rupture of one or both ACL bundles were included in the present trial. The partial ACL tears were arthroscopically assessed and classified according to a new five step grading system. All patients were treated by trephination of the femoral ACL stump and intra-ligamentary application of ACP. The postoperative outcome was evaluated by both subjective scores and stability testing up to a mean of 25.1 months' follow-up. Adverse events and failure rate were also documented.

RESULTS:

Clinical outcome was good to excellent with IKDC subjective 82.7 (SD 11.8), Lysholm 87.6 (SD 8.1), Tegner 5.3 (SD 2.1), Cincinnati 88.7 (SD 14.8). The failure rate (i.e. persisting knee instability assessed clinically or by rolimeter) was 12.5%. At objective measurements, knee joints showed a firm endpoint in Lachman test, negative pivot shift phenomenon and a significant reduction in AP-laxity compared to pre-operative status by rolimeter testing (p = 0.002). Return to sport practice was achieved after mean 4.8 months (SD 4.1).

CONCLUSIONS:

ACL stump trephination and concomitant intra-ligamentary application of ACP revealed promising results at mid-term follow-up to treat partial ACL lesions.

KEYWORDS:

ACP; Autologous conditioned plasma; Knee; Partial ACL rupture; Preservation technique

PMID:
29383441
DOI:
10.1007/s00402-018-2885-1
[Indexed for MEDLINE]

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