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Biologic agents for anterior cruciate ligament healing: a systematic review

World Journal of Orthopedics 2016年第9期7卷 592-603页

作者： Berardo Di Matteo Markus Loibl Luca Andriolo Giuseppe Filardo Johannes Zellner Matthias Koch Peter Angele ⅠOrthopaedic and Traumatologic Clinic - Biomechanics and Technology Innovation Laboratory Rizzoli Orthopaedic Institute Department of Trauma Surgery University Regensburg Medical Centre sporthopaedicum regensburg

AIM To systematically review the currently available literature concerning the application of biologic agents such as platelet-rich plasma(PRP) and stem cells to promote anterior cruciate ligament(ACL) *** A systematic review of the literature was performed on the use of biologic agents(i.e., PRP or stem cells) to favor ACL healing during reconstruction or repair. The following inclusion criteria for relevant articles were used: Clinical reports of any level of evidence, written in English language, on the use of PRP or stem cells during ACL reconstruction/repair. Exclusion criteria were articles written in other languages, reviews, or studies analyzing other applications of PRP/stem cells in knee surgery not related to promoting ACL *** The database search identified 394 records that were screened. A total of 23 studies were included in the final analysis: In one paper stem cells were applied for ACL healing, in one paper there was a concomitant application of PRP and stem cells, whereas in the remaining21 papers PRP was used. Based on the ACL injury pattern, two papers investigated biologic agents in ACL partial tears whereas 21 papers in ACL *** at the quality of the available literature, 17 out of 21 studies dealing with ACL reconstruction were randomized controlled trials. Both studies on ACL repair were case *** There is a paucity of clinical trials investigating the role of stem cells in promoting ACL healing both in case of partial and complete tears. The role of PRP is still controversial and the only advantage emerging from the literature is related to a better graft maturation over time, without documenting beneficial effects in terms of clinical outcome, bone-graft integration and prevention of bony tunnel enlargement.

关键词： Platelet-rich plasma Growth factors Stem cells Anterior cruciate ligament reconstruction Anterior cruciate ligament repair Anterior cruciate ligament healing Sports medicine Regenerative medicine

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