Use of Platelet-Rich Plasma for Patellar Tendon and Medial Collateral Ligament Injuries: Best Current Clinical Practice

J Knee SurgDOI: 10.1055/s-0034-1384671Platelet-rich plasmas (PRPs) are complex molecular therapies prepared from the patient's own blood through minimal manipulation. Clinical studies examining the efficacy of PRPs to manage patellar tendinopathy and medial collateral ligament (MCL) injuries have been reviewed. We found three controlled trials, two of them randomized, and seven case series in the management of patellar tendinopathy. In addition, three other randomized studies showed that PRPs help to regenerate the patellar tendon harvest site for anterior cruciate ligament reconstruction and to reduce patellar donor site morbidity. On the other hand, the use of PRP in MCL injuries is reported in a single case study. Seven of the 11 studies used leukocyte and PRP which was buffered in four studies. Seven of the 11 studies applied two or three injections. Given the heterogeneity of PRP protocols and the paucity of high-quality data, the most effective approach to guide clinical decisions regarding patellar tendinopathy cannot be deduced from the present published studies.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Special Focus Section Source Type: research

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AbstractPurpose of ReviewThe purpose of this review is to discuss relevant anatomy and pathoanatomy in the knee following anterior cruciate ligament reconstruction, risk factors for contralateral ACL tear, and mechanisms of contralateral injuries in the pediatric population.Recent FindingsContralateral ACL rupture rates following ACL reconstruction (ACLR) range from 4% to 42%. Pediatric patients show increased risk compared with adults, likely due to inherent anatomical differences along with biomechanical and neuromuscular changes that occur in both the operative and contralateral knees following index ACLR. Pediatric ath...
Source: Current Reviews in Musculoskeletal Medicine - Category: Orthopaedics Source Type: research
Condition:   Anterior Cruciate Ligament Injuries Interventions:   Procedure: Immediate anterior cruciate ligament reconstruction;   Other: Rehabilitation;   Procedure: Optional delayed anterior cruciate ligament reconstruction Sponsors:   Universitaire Ziekenhuizen Leuven;   Federaal Kenniscentrum voor de Gezondheidszorg;   Centre Hospitalier Universitaire de Liège Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionsThe present meta-analysis shows that patients older than 40  years achieve comparable clinical outcomes to those of younger patients following primary ACL reconstruction. This evidence may push the surgeons toward a more aggressive approach in this specific cohort of patients.Level of evidenceIII.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
ConclusionsThis comparative study shows that flexible reamers can reproduce a desired femoral tunnel position with only small improvements of no clinical relevance. As this can be achieved without hyperflexing the knee, these systems can be used for  all patients (even when hyperflexion is a challenge).Level of evidenceI.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
This study aimed to analyse the evolvement of joint laxity and graft compliance of short hamstring tendon grafts after ACL reconstruction (ACLR).MethodsForty-seven patients that underwent ACLR were retrospectively enrolled. Joint laxity was quantified with a GNRB® arthrometer before surgery, then at 15  days, at 1/3/6/9 months (M1–M9), at 1 year postoperatively and then again at the last mean follow-up (FU) of 14.7 ± 3.0 months. The side-to-side laxity difference (ΔL in mm) was measured at 30 and 60  N at every FU, additionally at 90 N from M3 on and at 134...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
The aim of this study was to compare the biomechanics of a four-strand hamstring graft with a tripled semitendinosus graft, with and without adjustable extra-cortical button fixation, in a cadaveric model.
Source: Journal of Experimental Orthopaedics - Category: Orthopaedics Authors: Tags: Research Source Type: research
We appreciate the interest and comments from Manara et al. regarding our published technical note “Hamstring Braid Graft Technique for Anterior Cruciate Ligament Reconstruction”.1 In our published article we described a step-by-step technical note presenting a novel “in vivo” hamstring braid graft configuration for anterior cruciate ligament (ACL) reconstruction that could potentially ov ercome some of the known disadvantages of hamstring autograft.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Letter to the Editor Source Type: research
We took interest in reading the article “Hamstring Braid Graft Technique for Anterior Cruciate Ligament Reconstruction” (1) published in Arthroscopy Techniques in Aug 2019 and would like to make a number of observations. We agree that when choosing the type and preparation technique of ACL reconstruction grafts, there are desirable ef fects in ensuring a sufficient graft diameter to maximize strength, and novel solutions to the current limitations in hamstring autografts are welcomed. The authors describe a technique to do this by braiding the graft strands, which they hypothesize would lead to a stronger graft...
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Letter to the Editor Source Type: research
wn O’Flynn Anterior cruciate ligament (ACL) injuries are common among athletes. Despite a successful return to sport (RTS) for most of the injured athletes, a significant proportion do not return to competitive levels, and thus RTS post ACL reconstruction still represents a challenge for clinicians. Wearable sensors, owing to their small size and low cost, can represent an opportunity for the management of athletes on-the-field after RTS by providing guidance to associated clinicians. In particular, this study aims to investigate the ability of a set of inertial sensors worn on the lower-limbs by rugby players...
Source: Sensors - Category: Biotechnology Authors: Tags: Article Source Type: research
AbstractPurposeTo study the effect of age, duration of injury, type of graft and concomitant knee injuries on return to sports after anterior cruciate ligament (ACL) reconstruction.MethodOne-hundred and sixteen athletes underwent ACL reconstruction using either bone –patellar tendon–bone graft (BPTB;n = 58) or semitendinosus-gracilis graft (n = 58), depending upon their random number sequences. Five variables were analyzed in terms of their effect on return to sports-age, type of graft, time interval between injury and surgery, chondral damage and meniscal tears.ResultsFifty-three ou...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
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