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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

CG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical). PRPG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical).
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Related In: Results  -  Collection


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fig5: CG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical). PRPG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical).

Mentions: Finally, the mean tunnel diameter at one year was larger in the entrance of the tunnels compared to the middistance, with the latter being subsequently larger compared to the diameter at the apex. This finding was constantly present in both groups. (Figure 5) and there was no significant difference between the 2 groups with regard to the tunnel diameters in these 3 areas from baseline to the 12th month's assessment (Table 4).


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)

CG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical). PRPG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4590903&req=5

fig5: CG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical). PRPG mean tunnel dilation at the entrance, middistance, and bottom end of the tunnel at 12 months. Horizontal red line shows the mean drilled diameter and shadowed area demonstrates the shape of tunnel dilation (conical).
Mentions: Finally, the mean tunnel diameter at one year was larger in the entrance of the tunnels compared to the middistance, with the latter being subsequently larger compared to the diameter at the apex. This finding was constantly present in both groups. (Figure 5) and there was no significant difference between the 2 groups with regard to the tunnel diameters in these 3 areas from baseline to the 12th month's assessment (Table 4).

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