AAOS2017: PRFM-augmented ACL reconstruction yields no effect on graft healing/thickness

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
54 patients scheduled for anterior cruciate ligament (ACL) reconstruction with a quadruple-stranded semitendinosus tendon autograft were randomized to have the graft augmented with platelet-rich fibrin matrix (PRFM) membranes, or to a control group with no PRFM augmentation. Patients were followed-up on standard and contrast-enhanced MRI over a 12-month period, graft signal intensity was used to measure graft healing, and cross-sectional area was used to measure graft thickness. Results demonstrated no Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
The interest in biologic augmentation of orthopaedic procedures has increased in the past decade, with many studies evaluating the potential positive impact of platelet-rich plasma or platelet-rich fibrin matrices (PRFM) in various surgical interventions. Nevertheless, the body of evidence for the use of biological augmentation in ACL reconstruction is still quite limited. This study sought to evaluate the potential of PRFM to improve graft healing and thickness within the first postoperative year following ACL reconstruction.
What was the principal research question?
In ACL reconstruction, does augmentation with a platelet-rich fibrin matrix result in significantly greater graft healing and thickness, as assessed using signal intensity and cross-sectional area on MRI, when compared to non-augmented procedures and assessed over a 12-month follow-up?
Population: 54 patients, 18-50 years of age, scheduled for ACL reconstruction with a quadruple-stranded semitendinosus tendon autograft.
Intervention: PRFM group: During graft preparation, two membranes of platelet rich fibrin matrix, which ran the length of the graft, were sewn in the centre of the four strands. (Mean age: 29.0+/-6.8)
Comparison: Control group: ACL reconstruction was completed using an autograft that had not been augmented with PRFM. (Mean age: 30.6+/-7.9)
Outcomes: Standard and contrast-enhanced MRIs were taken to assess graft signal intensity and cross-sectional area at five locations along the graft: at the junction of the tibial tunnel, the distal intra-articular portion of the graft, the middle intra-articular portion of the graft, the proximal intra-articular portion of the graft, and at the junction of the femoral tunnel.
Methods: RCT
Time: Follow-up scheduled for 3, 6 and 12 months postoperatively.
What were the important findings?
CONTENT IS LOCKED
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.