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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.

Starantzis KA, Mastrokalos D, Koulalis D, Papakonstantinou O, Soucacos PN, Papagelopoulos PJ - J Sports Med (Hindawi Publ Corp) (2014)

Bottom Line: Results.There was a statistical significant difference in the mid distance of the tunnels between the two groups.The role of mechanical factors, however, remains important.

View Article: PubMed Central - PubMed

Affiliation: 1st Department of Orthopaedics, ATTIKON University General Hospital, University of Athens, 124 62 Athens, Greece.

ABSTRACT
Purpose. In this study, the early and midterm clinical and radiological results of the anterior cruciate ligament (ACL) reconstruction surgery with or without the use of platelet rich plasma (PRP) focusing on the tunnel-widening phenomenon are evaluated. Methods. This is a double blind, prospective randomized study. 51 patients have completed the assigned protocol. Recruited individuals were divided into two groups: a group with and a group without the use of PRPs. Patients were assessed on the basis of MRI scans, which were performed early postoperatively and repeated at least one-year postoperatively. The diameter was measured at the entrance, at the bottom, and at the mid distance of the femoral tunnel. Results. Our study confirmed the existence of tunnel widening as a phenomenon. The morphology of the dilated tunnels was conical in both groups. There was a statistical significant difference in the mid distance of the tunnels between the two groups. This finding may support the role of a biologic response secondary to mechanical triggers. Conclusions. The use of RPRs in ACL reconstruction surgery remains a safe option that could potentially eliminate the biologic triggers of tunnel enlargement. The role of mechanical factors, however, remains important.

No MeSH data available.


Related in: MedlinePlus

Comparison of femoral tunnel's axial MRI cuts performed on the same patient 1 and 12 months following ACL reconstruction. (a) Proximal 1 month, (b) middistance 1 month, (c) distal 1 month, (d) proximal 12 months, (e) middistance 12 months, and (f) distal 12 months.
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Related In: Results  -  Collection


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fig4: Comparison of femoral tunnel's axial MRI cuts performed on the same patient 1 and 12 months following ACL reconstruction. (a) Proximal 1 month, (b) middistance 1 month, (c) distal 1 month, (d) proximal 12 months, (e) middistance 12 months, and (f) distal 12 months.

Mentions: An experienced musculoskeletal radiologist (Olympia Papakonstantinou), with no access to the clinical information, recorded, on two different occasions, the bone tunnel enlargement (by measuring the transverse diameters perpendicularly to the axis of the femoral tunnel). The diameters were measured at the entrance, at the bottom, and at the middistance of the femoral tunnel (Figure 3). The measurements were digitally obtained perpendicularly to the long axis of the tunnel (Figure 4). The highest widening measurement was recorded for each of the segments.


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

Starantzis KA, Mastrokalos D, Koulalis D, Papakonstantinou O, Soucacos PN, Papagelopoulos PJ - J Sports Med (Hindawi Publ Corp) (2014)

Comparison of femoral tunnel's axial MRI cuts performed on the same patient 1 and 12 months following ACL reconstruction. (a) Proximal 1 month, (b) middistance 1 month, (c) distal 1 month, (d) proximal 12 months, (e) middistance 12 months, and (f) distal 12 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4590903&req=5

fig4: Comparison of femoral tunnel's axial MRI cuts performed on the same patient 1 and 12 months following ACL reconstruction. (a) Proximal 1 month, (b) middistance 1 month, (c) distal 1 month, (d) proximal 12 months, (e) middistance 12 months, and (f) distal 12 months.
Mentions: An experienced musculoskeletal radiologist (Olympia Papakonstantinou), with no access to the clinical information, recorded, on two different occasions, the bone tunnel enlargement (by measuring the transverse diameters perpendicularly to the axis of the femoral tunnel). The diameters were measured at the entrance, at the bottom, and at the middistance of the femoral tunnel (Figure 3). The measurements were digitally obtained perpendicularly to the long axis of the tunnel (Figure 4). The highest widening measurement was recorded for each of the segments.

Bottom Line: Results.There was a statistical significant difference in the mid distance of the tunnels between the two groups.The role of mechanical factors, however, remains important.

View Article: PubMed Central - PubMed

Affiliation: 1st Department of Orthopaedics, ATTIKON University General Hospital, University of Athens, 124 62 Athens, Greece.

ABSTRACT
Purpose. In this study, the early and midterm clinical and radiological results of the anterior cruciate ligament (ACL) reconstruction surgery with or without the use of platelet rich plasma (PRP) focusing on the tunnel-widening phenomenon are evaluated. Methods. This is a double blind, prospective randomized study. 51 patients have completed the assigned protocol. Recruited individuals were divided into two groups: a group with and a group without the use of PRPs. Patients were assessed on the basis of MRI scans, which were performed early postoperatively and repeated at least one-year postoperatively. The diameter was measured at the entrance, at the bottom, and at the mid distance of the femoral tunnel. Results. Our study confirmed the existence of tunnel widening as a phenomenon. The morphology of the dilated tunnels was conical in both groups. There was a statistical significant difference in the mid distance of the tunnels between the two groups. This finding may support the role of a biologic response secondary to mechanical triggers. Conclusions. The use of RPRs in ACL reconstruction surgery remains a safe option that could potentially eliminate the biologic triggers of tunnel enlargement. The role of mechanical factors, however, remains important.

No MeSH data available.


Related in: MedlinePlus