Effect of Thrombocyte-rich Plasma on Prevention of Tunnel Enlargement in Anterior Cruciate Ligament (ACL) Reconstruction

Abstract

This study was conducted to 44 patients, to whom both hamstring tendon autograft and transtibial ACL reconstruction were applied, having treatment in Clinic of Orthopedics and Traumatology in İzmir Bozyaka Training and Research Hospital between dates of March 2014 and July 2015. Treatment group (18 patients, subjected to PRP) and control group (26 patients) selected with random method were taken. Minimum age in the treatment group was 16 and maximum age was 38, having an average of (26±6,96). Minimum age in the treatment group was 14 and maximum age was 43, having an average of (26,54±7,93). In this group, 27 patients have had operation on right knee (61%), 17 patients on left knee (39%). Follow up period after surgery is at least 4 months, at most 16 months, with an average period of 12 months. Injury reason of ACL was sport injury for 36 patients, injury of falling down from height for 1 patient and injury of occupational accident for 6 patients. Reasons of application of these patients are distrust for 30 patients, pain for 10 patients and locked-in findings for 4 patients. General physical examinations of these patients were performed prior to surgery, and direct graphy and MR imaging method was used for the patients. The patients were evaluated with IKDC score, Lysholm score, Tegner activity scale, KT-1000 arthrometer device and multi-slice tomography in preoperative and postoperative methods. The same physical treatment protocol was applied for all patients. Measurements carried out for tomography standardization of the patients were evaluated on coronal, sagittal and axial plans after 64-slice MSCT scanning. BT slice thickness was calculated as 1 mm using automatic software with 0.75 mm retrorecons. Measurements were evaluated by the same radiology expert. On comparison of radiological data between both groups, although tunnel enlargement is less in PRP-administered group for femoral tunnel, the result was not significant statistically. No difference was seen between clinical examination results and used grading scales. It was seen that PRP use was not effective in preventing or decreasing femoral and tibial tunnel enlargement in patients having ACL reconstruction with Hamstring. There was a decrease in tunnel enlargement in case of the use of PRP, however, this decrease was not clinically significant. In line with these data, routine use of PRP is not recommended for the prevention of tunnel enlargement after ACL reconstruction. KeyWords: Thrombocyte-rich plasma (PRP), Tunnel enlargement, ACL reconstruction, BT scan