2023 Specialty Day All-Access Pass-ACL Reconstruction and Repair: What Is the Role for Biologics?

Video Transcription

Video Summary

The video discusses the use of orthobiologics in the treatment of ACL injuries. It mentions the use of PRP (platelet-rich plasma) and MSCs (mesenchymal stem cells) derived from adipose tissue or bone marrow. The video reviews several systematic reviews and studies on the effectiveness of PRP in ACL reconstruction. Results showed that PRP improved pain scores and knee function in the short and medium term but did not improve long-term outcomes. The use of PRP in ACL reconstruction also did not improve knee stability or reduce graft tunnel enlargement. The video also discusses the use of platelet-rich fibrin (PRF) and the results of a comparative MRI study that showed superior graft integration and maturation with PRF. The use of collagen wrapping with PRF did not improve overall graft survival rates. The video briefly mentions a study on the use of mesenchymal stem cells, which showed potential in modulating pathologic processes following ACL reconstruction. Finally, it discusses the use of a biologic scaffold called BEAR (biologic-enhanced ACL repair), which showed non-inferior patient-reported outcomes and superior hamstring muscle strength compared to autograft ACL reconstruction. The video concludes by emphasizing the need for more well-designed controlled studies to determine the exact role and benefits of biologic agents in ACL repair and reconstruction.

Asset Caption

Leah C. Brown, M.D.

Keywords

orthobiologics

ACL injuries

PRP

MSCs

biologic agents