RESUMO
PURPOSE: Anterior cruciate ligament (ACL) rupture is the most common complete ligamentous injury in the knee. Many studies explored ACL graft integration and maturation, but only a few assessed the application of platelet rich fibrin matrix (PRFM) as augmentation for ACL reconstruction. The main aim of this study was to test the PRFM augmentation in terms of graft-bone integration and knee stability. The secondary aim was to investigate patient-reported functional status. METHODS: Prospective evaluation has been done in two consecutive series of patients who underwent ACL reconstruction with semitendinosus and gracilis (STG) grafts: 14 patients were operated with PRFM augmentation and 14 patients without PRFM augmentation. Objective clinical evaluation (Rolimeter) and MRI evaluation were performed at 1 year from surgery. Subjective evaluation (IKDC) was performed pre-operatively and at 6 months, 1 and 2 years from surgery. RESULTS: A statistically significant difference was not detected between the two groups in terms of MRI and objective clinical evaluation, although PRFM-augmented patients showed a statistically significant higher clinical improvement. CONCLUSIONS: The procedure described for PRFM augmentation in ACL STG reconstruction does not improve radiologic graft integration and knee stability after 1 year and should not be used by clinicians to this purpose. However, it may result in a short-term improvement of patient-reported knee function, and future research should focus on further developing PRP treatment to optimize ACL clinical outcome. LEVEL OF EVIDENCE: III.
Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/cirurgia , Fibrina , Traumatismos do Joelho/cirurgia , Plasma Rico em Plaquetas , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Instabilidade Articular/fisiopatologia , Articulação do Joelho/patologia , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , RupturaRESUMO
The authors report 31 cases of acute severe capsuloligamentous lateral lesions of the ankle joint, 12 of which were treated surgically and 18 with a below knee plaster cast. An evaluation of the results at an average 20 months follow-up showed the superiority of the conservative method.
