caa a22 4500 605457956 CHVBK 20210128100226.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00167-014-3380-z doi (NATIONALLICENCE)springer-10.1007/s00167-014-3380-z Does fibrin clot really enhance graft healing after double-bundle ACL reconstruction in a caprine model? [Elektronische Daten] [Daniel Hensler, Kenneth Illingworth, Volker Musahl, Zachary Working, Tetsuo Kobayashi, Motoko Miyawaki, Stephan Lorenz, Michelle Witt, James Irrgang, Johnny Huard, Freddie Fu] Purpose: Graft healing following anterior cruciate ligament (ACL) reconstruction is a complex process characterized by phases of healing that lead to ACL remodelling. Our hypothesis is that fibrin clot addition to ACL reconstruction will result in advanced graft remodelling and healing when compared to a control group at 12weeks as observed by histology, immunohistochemistry and magnetic resonance imaging (MRI). Methods: Eleven Spanish Boar goats underwent double-bundle ACL reconstruction: 8 were analysed and 3 were excluded. Group 1 was treated with DB ACL reconstruction utilizing autologous fibrin clots (n=4), and group 2 was treated with standard DB ACL-R (n=4). Histological and radiographic analysis was performed at 12weeks. Each animal underwent 3-T MRI immediately after euthanization for evaluation of graft signal intensity utilizing the signal noise quotient (SNQ). Specimens were then sectioned and stored for standard histological and immunohistochemistry testing. Results: The mean ligament tissue maturity index score was significantly higher for group 1 (15±2.3) compared with group 2 (7.7±5.2) (p<0.05). The mean vascularity (cell/mm2) for group 1 was 7.1±1.3 and 9.3±3.1 for group 2 (n.s.). The mean collagen type 1 (% 50×field) for group 1 was 35.8±22.1 and 19.9±20.5 for group 2 (n.s.). The mean SNQ for the AM bundle was 1.1±0.7 for group 1 and 3.1±1.8 for group 2 (n.s.). The mean SNQ for the total PL bundle was significantly lower for group 1 (1.1±0.7) compared with group 2 (3.7±1.3) (p<0.05). There was a significant correlation between the vascularity and the ligament tissue maturity index score as well as between collagen type 1 and SNQ, both AM and PL bundles (p<0.05). Conclusion: The use of fibrin clot in ACL reconstruction in a caprine model demonstrated improved healing with respect to histological analysis of the intra-articular ACL reconstruction segment and decreased signal intensity on MRI. It may lead to improved graft healing and maturation. By accelerating the intra-articular healing and ligamentization, the outcome of patients after ACL-R can be improved with faster return to sports and daily activity. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2014 Anterior cruciate ligament nationallicence Fibrin clot nationallicence ACL graft healing nationallicence Double-bundle reconstruction nationallicence Graft remodelling nationallicence Hensler Daniel Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Illingworth Kenneth Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Musahl Volker Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Working Zachary Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Kobayashi Tetsuo Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Miyawaki Motoko Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Lorenz Stephan Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Witt Michelle Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Irrgang James Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Huard Johnny Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Fu Freddie Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/3(2015-03-01), 669-679 0942-2056 23:3<669 2015 23 167 https://doi.org/10.1007/s00167-014-3380-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3380-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hensler Daniel Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Illingworth Kenneth Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Musahl Volker Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Working Zachary Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Kobayashi Tetsuo Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Miyawaki Motoko Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Lorenz Stephan Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Witt Michelle Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Irrgang James Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Huard Johnny Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Fu Freddie Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/3(2015-03-01), 669-679 0942-2056 23:3<669 2015 23 167