The impact of platelet-rich plasma on the prevention of tunnel widening in anterior cruciate ligament reconstruction using quadrupled autologous hamstring tendon: A randomised 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.
Patients undergoing ACL reconstruction using a hamstring graft were randomly allocated
either to have PRP introduced into the tunnels peri-operatively or not. 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.
Each group comprised 25 patients, and at three months post-operatively all were painfree
with stable knees, a negative Lachman test and a good range of movement.
Arthrometric results had improved significantly in both groups (p < 0.001). Despite slightly
less tunnel widening in the PRP group, there was no significant difference between the
groups at the femoral opening or the mid-tunnel (p = 0.370 and p = 0.363, respectively) nor
at the tibial opening or mid-tunnel (p = 0.333 and p = 0.177, respectively).
We conclude that PRP has no significant effect in preventing tunnel widening after ACL
reconstruction.