Non-surgical treatment of anterior cruciate ligament tears with percutaneous bone marrow concentrate and platelet products versus exercise therapy: a randomized-controlled, crossover trial with 2-year follow-up.

研究概要

51 patients with MRI-confirmed partial or complete non-retracted anterior cruciate ligament (ACL) tears were enrolled in a randomized controlled, open-label, crossover trial. Patients were randomized to exercise therapy or bone marrow concentrate (BMC) combined with platelet products. Three patients randomized to exercise therapy withdrew prior to starting treatment, leaving 14 patients who completed at least 3 months of exercise therapy, all of whom subsequently crossed over to receive BMC (48 total analyzed). The outcomes of interest were patient-reported knee function and pain - assessed using the International Knee Documentation Committee (IKDC) subjective knee form - Lower Extremity Functional Scale, Numeric Pain Scale, and modified Single Assessment Numeric Evaluation. Other outcomes include MRI-based assessment of ACL integrity, return-to-activity measures, and treatment failure defined as ACL reconstruction or re-injury. Outcomes were assessed at baseline and at 1, 3, 6, 12, and 24 months. Overall, the results of the study revealed that patients treated with BMC and platelet products experienced significantly greater early functional improvement than those treated with exercise therapy alone, with sustained improvements in pain and function through 24 months. Exercise therapy alone did not result in significant early improvements.