caa a22 4500 605458715 CHVBK 20210128100230.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00167-014-2932-6 doi (NATIONALLICENCE)springer-10.1007/s00167-014-2932-6 Increased platelet concentration does not improve functional graft healing in bio-enhanced ACL reconstruction [Elektronische Daten] [Braden Fleming, Benedikt Proffen, Patrick Vavken, Matthew Shalvoy, Jason Machan, Martha Murray] 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. Springer-Verlag Berlin Heidelberg, 2014 Anterior cruciate ligament nationallicence Collagen nationallicence Platelet nationallicence Reconstruction nationallicence Biomechanics nationallicence Osteoarthritis nationallicence Fleming Braden Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA aut Proffen Benedikt Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA aut Vavken Patrick Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA aut Shalvoy Matthew Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA aut Machan Jason Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA aut Murray Martha Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 1161-1170 0942-2056 23:4<1161 2015 23 167 https://doi.org/10.1007/s00167-014-2932-6 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/s00167-014-2932-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fleming Braden Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA aut NATIONALLICENCE 700 1- Proffen Benedikt Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Vavken Patrick Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Shalvoy Matthew Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA aut NATIONALLICENCE 700 1- Machan Jason Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI, USA aut NATIONALLICENCE 700 1- Murray Martha Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 1161-1170 0942-2056 23:4<1161 2015 23 167