期刊
AMERICAN JOURNAL OF SPORTS MEDICINE
卷 37, 期 8, 页码 1554-1563出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0363546509332257
关键词
ACL; reconstruction; platelets; laxity; mechanical properties; healing; collagen-platelet composite; allograft
资金
- NIAMS NIH HHS [R01-AR052772, R01 AR049199-05, R01 AR056834-01, R01 AR049199, R01-AR056834, R01 AR052772, R01-AR049199, R01 AR052772-03, R01 AR056834] Funding Source: Medline
Background: The outcome of anterior cruciate ligament (ACL) reconstruction is variable, and many patients have increased joint laxity postoperatively. Hypothesis: Placement of a collagen-platelet composite (CPC) around the graft at the time of ACL reconstruction decreases postoperative knee laxity and improves the structural properties of the graft compared with standard ACL reconstruction. Study Design: Controlled laboratory study. Methods: Thirteen immature pigs underwent unilateral ACL reconstruction with a bone-patellar tendon-bone allograft. In 6 pigs, a standard allograft was used to reconstruct the ACL. In 7 pigs, a CPC was placed around the allograft. After 15 weeks of healing, the animals were euthanized, and the anterior-posterior (AP) knee laxity and structural properties of the graft were measured. Qualitative histology of the grafts was also performed. Results: The AP laxity values of the reconstructed knees, normalized to the contralateral control, were significantly reduced by 28% and 57% at 60 and 90 of knee flexion, respectively, with the addition of CPC (P < .001). Significant improvements in the graft structural properties were also found; the normalized yield (P = .044) and maximum failure loads (P = .025) of the CPC group were 60% higher than the standard ACL-reconstructed group. Although cellular and vessel infiltration were observed in the grafts of both groups, regions of necrosis were present only in the standard ACL-reconstructed group. Conclusion: These data demonstrate that the application of CPC at the time of ACL reconstruction improves the structural properties of the graft and reduces early AP knee laxity in the porcine model after 15 weeks of healing. Clinical Relevance: Application of a CPC to an ACL graft at the time of surgery decreased knee laxity and increased the structural properties of the graft after 15 weeks of healing.
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