Increased platelet concentration does not improve functional graft healing in bio-enhanced ACL reconstruction

Verfasser / Beitragende:
[Braden Fleming, Benedikt Proffen, Patrick Vavken, Matthew Shalvoy, Jason Machan, Martha Murray]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/4(2015-04-01), 1161-1170
Format:
Artikel (online)
ID: 605458715
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024 7 0 |a 10.1007/s00167-014-2932-6  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-2932-6 
245 0 0 |a Increased platelet concentration does not improve functional graft healing in bio-enhanced ACL reconstruction  |h [Elektronische Daten]  |c [Braden Fleming, Benedikt Proffen, Patrick Vavken, Matthew Shalvoy, Jason Machan, Martha Murray] 
520 3 |a Purpose: The use of an extracellular matrix scaffold (ECM) combined with platelets to enhance healing of an anterior cruciate ligament (ACL) graft ("bio-enhanced ACL reconstruction”) has shown promise in animal models. However, the effects of platelet concentration on graft healing remain unknown. The objectives of this study were to determine whether increasing the platelet concentration in the ECM scaffold would (1) improve the graft biomechanical properties and (2) decrease cartilage damage after surgery. Methods: Fifty-five adolescent minipigs were randomized to five treatment groups: untreated ACL transection (n=10), conventional ACL reconstruction (n=15) and bio-enhanced ACL reconstruction using 1× (n=10), 3× (n=10) or 5× (n=10) platelet-rich plasma. The graft biomechanical properties, anteroposterior (AP) knee laxity, graft histology and macroscopic cartilage integrity were measured at 15weeks. Results: The mean linear stiffness of the bio-enhanced ACL reconstruction procedure using the 1× preparation was significantly greater than traditional reconstruction, while the 3× and 5× preparations were not. The failure loads of all the ACL-reconstructed groups were equivalent but significantly greater than untreated ACL transection. There were no significant differences in the Ligament Maturity Index or AP laxity between reconstructed knees. Macroscopic cartilage damage was relatively minor, though significantly less when the ECM-platelet composite was used. Conclusions: Only the 1× platelet concentration improved healing over traditional ACL reconstruction. Increasing the platelet concentration from 1× to 5× in the ECM scaffold did not further improve the graft mechanical properties. The use of an ECM-platelet composite decreased the amount of cartilage damage seen after ACL surgery. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Anterior cruciate ligament  |2 nationallicence 
690 7 |a Collagen  |2 nationallicence 
690 7 |a Platelet  |2 nationallicence 
690 7 |a Reconstruction  |2 nationallicence 
690 7 |a Biomechanics  |2 nationallicence 
690 7 |a Osteoarthritis  |2 nationallicence 
700 1 |a Fleming  |D Braden  |u Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA  |4 aut 
700 1 |a Proffen  |D Benedikt  |u Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA  |4 aut 
700 1 |a Vavken  |D Patrick  |u Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA  |4 aut 
700 1 |a Shalvoy  |D Matthew  |u Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA  |4 aut 
700 1 |a Machan  |D Jason  |u Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA  |4 aut 
700 1 |a Murray  |D Martha  |u Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/4(2015-04-01), 1161-1170  |x 0942-2056  |q 23:4<1161  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-2932-6  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-2932-6  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Fleming  |D Braden  |u Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Proffen  |D Benedikt  |u Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Vavken  |D Patrick  |u Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Shalvoy  |D Matthew  |u Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Machan  |D Jason  |u Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Murray  |D Martha  |u Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/4(2015-04-01), 1161-1170  |x 0942-2056  |q 23:4<1161  |1 2015  |2 23  |o 167