New biological approaches in the reconstruction of anterior cruciate ligament (ACL)
Background: Anterior cruciate ligament (ACL) rupture is one of the most common knee injuries. The operative reconstruction is usually performed as the standard treatment. The success of the operative technique is between 73–95 %, and 37–75 % of patients return to the preoperative physical activity....
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Slovenian Medical Association
2010-05-01
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| Series: | Zdravniški Vestnik |
| Online Access: | http://vestnik.szd.si/index.php/ZdravVest/article/view/259 |
| Summary: | Background: Anterior cruciate ligament (ACL)
rupture is one of the most common knee injuries.
The operative reconstruction is usually performed
as the standard treatment. The success of
the operative technique is between 73–95 %, and
37–75 % of patients return to the preoperative
physical activity. The main problem after surgical
reconstruction is the long rehabilitation period.
Patients are not allowed to perform sports activities
for 6 months after surgery. The outcome after
ACL reconstruction depends upon the healing
of the graft in the bone tunnel and upon the ligamentization
of the intraarticular part of the graft;
this is a process during which the graft attains
the features of a native ACL. The biomechanical
factors (anatomical tunnel position, fixation, adequacy
of the graft and postoperative rehabilitation)
and biological response (revascularization
and the number of collagen fibers) seem to play a
crucial role after surgery. The biological response
can be accelerated with the use of growth factors
(GF), periosteum and mesenchymal stem cells
(MSCs). Nowadays platelet-rich plasma (PRP)
from autologous blood is applied at the graft insertion
site to promote healing and ligamentization
of the graft.
Conclusion: The review focuses on the factors
that influence the outcome of ACL reconstruction.
A better understanding of the graft’s biological
response and its modulation is the basis of
new approach in the treatment of ACL rupture,
which enables the patient and athlete to quicker
resume their everyday and sports activities. |
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| ISSN: | 1318-0347 1581-0224 |