Summary: Level II cohort study of consecutive patients managed with or without bone marrow aspiration concentrate augmentation (BMAC) during ACL reconstruction. At 6 months follow-up, BMAC did not improve graft maturation as seen on magnetic resonance imaging, and did not show differences for functional outcomes at 6 months, 12, and 30-month follow-up.

Background

There is ambiguous recent evidence regarding the use of healing adjuvants during anterior cruciate ligament reconstructions (ACL-R) procedures. Bone marrow aspiration concentrate (BMAC) has been proposed as a safe and potentially healing stimulation aid in animal models; however, clinical evidence is still scarce and controversial regarding imaging and functional results.

Purpose

Evaluate the imaging and functional outcomes of BMAC augmentation in ACL-R.

Methods

Cohort nonrandomized study in patients treated for primary ACL rupture using an autologous hamstring graft. Patients with multiligamentary knee injuries and revision surgeries were excluded. Two study groups were analyzed: Intervention (BMAC) and Control. Both groups were compared for operative times, graft maturation (magnetic resonance at 6 months from surgery), and functional outcomes (isokinetic tests at 6 months from surgery, and KOOS, IKDC, Lysholm, and Tegner at 0, 6, 12, and 30 months). BMAC was obtained from the intercondylar femoral notch during the reconstruction procedure.

Results

Forty-nine patients were selected (30 Intervention/19 Control). Both groups were comparable for age (p=0.845), sex (p=0.711), body mass index (p=0.121), and all pre-operative functional scores, except for a higher KOOS (Function in sport and recreation) in the Control group (p=0.035). Two (6.67%) and two (10.5%) patients from Intervention and Control group, respectively, lost follow-up at 30 months from surgery (p=0.548).
Operative times: The Intervention group showed significantly higher operative times than the Control group [63 minutes (48-90)/50 minutes (38-72); p<0.001].
Graft maturation: No differences regarding graft maturation were observed for tunnel integration (p=0.498; p=0.954) and graft ligamentization (p=0.582) between groups.
Isokinetic tests: No differences between groups in muscle deficit at 6 months, for both extensor [36% (11-68)/ 32% (15-73); p=0.339] and flexor muscles [15% (2-46)/14% (7-34); p=0.875].
Functional scores: No differences at 6, 12, and 30 months from surgery between groups. Both groups showed significant improvements between baseline and 6 months (p<0.001), and between 6 and 12 months (p<0.001).

Conclusion

BMAC did not improve ACL-R graft maturation and isokinetic tests at 6 months of follow-up, nor functional outcomes at 6, 12, and 30 months from surgery compared to a Control group; however, it increased operative time.

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Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction. Abstract Presentation 6 minutes Franco Della Vedova, ARGENTINA Hernan Galan, MD, ARGENTINA Daniel A. Slullitel, MD, Prof., ARGENTINA
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Combined Reconstruction Of The Medial Collateral Ligament And Anterior Cruciate Ligament Using Ipsilateral Semitendinosus Tendon And Opposite Semitendinosus With Ipsilateral Gracilis Tendon: A Minimum One-Year Follow-Up Study In NITOR.Dhaka,Bnagladesh Abstract Presentation 4 minutes Dibakar Sarkar, MS(Orthopaedic surgery),FACS(USA),AO fellow(Bangko, BANGLADESH
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Return To Elite Sport After ACL Reconstruction In 376 'Professional' Athletes Abstract Presentation 5 minutes Kyle Borque, MD, UNITED STATES Mary Jones, MSc, Grad. Dip. Phys., UNITED KINGDOM Ganesh Balendra, MBBS, AUSTRALIA Lukas Willinger, MD, GERMANY Vitor Hugo Pinheiro, MD, UNITED KINGDOM Andy Williams, MBBS, FRCS(Orth), FFSEM(UK), UNITED KINGDOM
Why, When and Who Fails Non-Operative Treatment of Anterior Cruciate Ligament Injury – An Exploratory Analysis of the COMPARE Trial Abstract Presentation 5 minutes Sabine van der Graaff, MD, NETHERLANDS Duncan E. Meuffels, MD, PhD, NETHERLANDS Sita Bierma-Zeinstra, MD, NETHERLANDS Eline van Es, MSc, NETHERLANDS Jan Verhaar, MD, PhD, Prof., NETHERLANDS Vincent Eggerding, MD, NETHERLANDS Max Reijman, PhD, NETHERLANDS
Value, Limitations And Recommendations For Use Of Metal-Reduction Knee MRI Sequences Following Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Brandon Zhao, MD, CANADA Nabil Khan, MBChB, MMED, FCS Orth, CANADA Mark F. Sommerfeldt, MD, CANADA Anukul Panu, MD, CANADA Jacob L Jaremko, MD, PhD, CANADA Catherine May Ting Hui, MD, FRCSC, CANADA
Skeletally Immature Patients with Classic Anterior Cruciate Ligament Bone Bruise Patterns Have a Higher Chance of Having an Intact Anterior Cruciate Ligament than Skeletally Mature Patients Abstract Presentation 6 minutes Aaron Baessler, MD, UNITED STATES Jessica M Buchman, MD, UNITED STATES Dexter Witte, MD, UNITED STATES Tyler Brolin, MD, UNITED STATES Thomas Ward Throckmorton, MD Frederick M. Azar, MD, UNITED STATES David Lee Bernholt, MD, UNITED STATES
Risk Factor Analysis for Graft Failure after Anterior Cruciate Ligament Reconstruction with or without mLET Abstract Presentation 7 minutes Filip R Hendrikx, MD, BELGIUM Koen Lagae, MD, BELGIUM Annemieke Van Haver, PhD, MSc, BELGIUM Peter Verdonk, MD, PhD, BELGIUM
Predicting Patient Lost to Follow-up in the STABILITY 1 Study: A Multi-centre, International, Randomized Controlled Trial of Young, Active Patients Undergoing Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Andrew Firth, PhD, CANADA Dianne M. Bryant, PhD, CANADA Andrew Johnson, PhD, CANADA Stability Study Group, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Validation of a Risk Calculator to Personalize Graft Choice and Reduce Rupture Rates for Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Hana Marmura, MPT, PhD, UNITED STATES Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR Kurt Paul Spindler, MD, UNITED STATES Michael W Kattan, PhD, UNITED STATES Isaac Briskin, MA, UNITED STATES Dianne M. Bryant, PhD, CANADA
In Vivo Measurement of Anterior Cruciate Ligament Elongation and Strain Rate during Increasingly Demanding Activities ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Caiqi Xu, MD, CHINA Tom Gale, MS, UNITED STATES William Anderst, PhD, UNITED STATES Freddie H. Fu, MD, UNITED STATES
Impingement Due to Graft Buckling Is More Prevalent after ACL Reconstructions with an Adjustable-Loop Compared to a Fixed-Loop Abstract Presentation 5 minutes Julian De Rover, NETHERLANDS Inge Van Den Akker-Scheek, PhD, NETHERLANDS Hugo Christiaan van der Veen, MD, PhD, NETHERLANDS
Quadriceps Tendon Vs. Hamstring Tendon Autograft In Primary Anterior Cruciate Ligament Reconstruction: A Matched-Pairs Study With A Mean Follow-Up Of 6.5 Years Award Winner 5 minutes Armin Runer, PD MD, GERMANY Aline Suter, MD, AUSTRIA Tommaso Roberti di Sarsina, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Peter Gföller, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Robert Csapo, PhD, AUSTRIA Christian Fink, MD, Prof., AUSTRIA

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Bone Marrow Aspiration Concentrate Augmentation in Anterior Cruciate Ligament Hamstring Autograft Reconstruction: Clinical and Functional Outcomes of a Cohort Study

Bone Marrow Aspiration Concentrate Augmentation in Anterior Cruciate Ligament Hamstring Autograft Reconstruction: Clinical and Functional Outcomes of a Cohort Study

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Bone Marrow Aspiration Concentrate Augmentation in Anterior Cruciate Ligament Hamstring Autograft Reconstruction: Clinical and Functional Outcomes of a Cohort Study

Bone Marrow Aspiration Concentrate Augmentation in Anterior Cruciate Ligament Hamstring Autograft Reconstruction: Clinical and Functional Outcomes of a Cohort Study

Background

Purpose

Methods

Results

Conclusion

More ISAKOS 2021: Global Content