Partial Anterior Cruciate Ligament Ruptures: Advantages by Intraligament Autologous Conditioned Plasma Injection and Healing Response Technique—Midterm Outcome Evaluation

Autor: Matthias Koch; Felix Mayr; Leonard Achenbach; Werner Krutsch; Siegmund Lang; Franz Hilber; Johannes Weber; Christian G. Pfeifer; Rebecca Woehl; Jürgen Eichhorn; Johannes Zellner; Michael Nerlich; Peter Angele
Sprache: Englisch
Veröffentlicht: 2018
Quelle: Directory of Open Access Journals: DOAJ Articles
Online Zugang: http://dx.doi.org/10.1155/2018/3204869
https://doaj.org/toc/2314-6133
https://doaj.org/toc/2314-6141
2314-6133
2314-6141
doi:10.1155/2018/3204869
https://doaj.org/article/f28f74a6e57c4dd2b81f9490e24bffb2
https://doi.org/10.1155/2018/3204869
https://doaj.org/article/f28f74a6e57c4dd2b81f9490e24bffb2
Erfassungsnummer: ftdoajarticles:oai:doaj.org/article:f28f74a6e57c4dd2b81f9490e24bffb2

Zusammenfassung

The historical treatment options for partial anterior cruciate ligament (ACL) ruptures were conservative therapy or ACL reconstruction by injured bundle or entire ACL replacement. In awareness of the regenerative potential of biologic agents such as mesenchymal stem cells or platelet rich plasma (PRP), the healing response technique was developed to preserve the injured ACL with better outcomes than the conservative therapy. Further improvement of this technique seems to be obtained by the additional application of PRP products. Thus, the aim of this study was to evaluate the midterm outcome after intraligament autologous conditioned plasma (ACP) by a clinical, scoring, and functional performance assessment. 42 patients were evaluated in this study. The failure rate was 9.5%. Outcome evaluation showed good to excellent results. The scores were IKDC subjective 83.2 (SD 14.5), Lysholm 85.5 (SD 15.5), Tegner 4.7 (SD 1.7), and Cincinnati 85.4 (SD 15.5) after a mean follow-up of 33 months. Clinical examination showed stable Lachman test, negative pivot shift phenomenon, and a significant reduction in AP-laxity compared to preoperative status (rolimeter preoperative: 1.9 (SD1.4); postoperative 0.6 (SD1.8), p=0.001) in all patients. Functional performance testing showed no significant differences between the injured and healthy side. Return to sport was achieved after a mean of 5.8 months (SD 3.6) in 71.1% of the included patients. In summary, this new treatment option revealed in midterm follow-up promising results to treat partial ACL lesions with a reduced need for conversion to ACL reconstruction and with a high percentage of return to preinjury sport activity.