The Impact of Platelet-Rich Plasma on the Prevention of Tunnel Widening in Anterior Cruciate Ligament Reconstruction Using Quadrupled Autologous Hamstring Tendon(A Randomized Clinical Trial)

The use of platelet-rich plasma (PRP) as an adjuvant to tissue repair is gaining favour in orthopaedic surgery. Tunnel widening after anterior cruciate ligament (ACL) reconstruction is a recognised phenomenon that could compromise revision surgery. The purpose of this study was to determine whether PRP might prevent tunnel widening in ACL reconstruction. In a randomized clinical study، during one year patients undergoing ACL reconstruction using a hamstring graft were randomly allocated either to have PRP introduced into the tunnels (group 1) peri-operatively or not (group 2). Each group comprised 25 patients. CT scanning of the knees was carried out on the day after surgery and at three months post-operatively and the width of the tunnels was measured. Patients were also evaluated clinically at three months، when laxity was also measured. Three months post-operatively، all patients were pain-free with stable knees، a negative Lachman test and a good range of movement. Arthrometric results had improved significantly in both groups (p<. 001). Despite slightly less tunnel widening in the PRP group، there was no significant difference between the groups neither at the femoral opening or the mid-tunnel nor at the tibial opening or mid-tunnel (p≥. 05). We conclude that PRP has no significant effect in preventing tunnel widening after ACL reconstruction.