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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item The effect of platelet-rich plasma in bone-tendon integration(WROCLAW MEDICAL UNIV, 2017-01-01) Agir, Ismail; Aytekin, Mahmut Nedim; Kucukdurmaz, Fatih; Kocaoglu, Baris; Cetinel, Sule; Karahan, MustafaBackground. The operative reconstruction of a torn or insufficient anterior cruciate ligament has become a routine surgical procedure in orthopedics. The long-term success of an anterior cruciate ligament reconstruction depends on the ability of the graft to heal adequately in a bone tunnel. Investigators studying reconstructions described healing within a tunnel as osseous ingrowth and incorporation. In particular, helping the healing using autologous material for the best integration process was a new idea that helped us to set up this study. Objectives. The purpose of this study is to show the effect of platelet-rich plasma on bone-tendon healing. Material and methods. Ten New Zealand rabbits were used. The study had 2 groups: (1) a study group including the right extremities of rabbits in which tendon-bone integration was strengthened by platelet-rich plasma and (2) a control group including the left extremities of rabbits in which tendon-bone integration was without platelet-rich plasma. On the 56th day postoperatively, the portion of the distal femur containing the tunnel was amputated following the euthanization process for histological evaluation. Results. In the histological evaluation of the tendon-integrated bone segments with platelet-rich plasma, the integration of tendon in the bone was successful without any necrosis formation in most of the tissues. However, in the control group without platelet-rich plasma, the integration was distorted in many zones and some cystic morphologies were present. Conclusions. The findings of this study showed that using platelet-rich plasma during tendon-to-bone implantation has positive effects histologically. In the literature, many studies are available that have investigated the effect of platelet-rich plasma on anterior cruciate surgery radiologically. However, the histological findings are more reliable than radiological findings because bone-tendon integration is a biological process.Item The triangle between the anterior and posterior cruciate ligaments: an arthroscopic anatomy study(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2015-01-01) Kaya, Alper; Koken, Murat; Akan, Burak; Karaguven, Doga; Guclu, BerkObjective: The goal of anterior cruciate ligament (ACL) reconstruction is to place the graft in closest proximity to the native ACL anatomy. This study aims to examine the angular relation between intact anterior and posterior cruciate ligaments (PCL) from an arthroscopic perspective. Methods: Forty patients (20 male, 20 female) with a mean age of 35.12 (range: 18-40) years that underwent knee arthroscopy for reasons other than ACL rupture were included in the study. Following diagnostic examination and repair of the primary pathology, the triangle between ACL and PCL was seen at different flexion degrees of the knee joint (120, 90, 60, and 30 degrees) through standard anterolateral (AL) and anteromedial (AM) portals. The narrow top angle of the triangle between the long intersecting axes of ACL and PCL was measured using recorded images by 3 blind observers. Results: The average ACL-PCL angle was 61 degrees, (standard deviation +/- 2 degrees) at 90 degrees of knee flexion. The angles were narrower when viewed through the AM portal. The degree of the angles was not affected by age, sex, body mass index (BMI), or the side (right or left) on which the procedure was performed. There was good-to-excellent intra-and interobserver reliability. Conclusion: The angular relation between intact ACL and PCL has the potential to provide a better view of the anatomy during arthroscopic ACL surgery. To perform better anatomic reconstructions, it is important to create a 60 degrees angle between the ACL graft and PCL (as viewed through AL portal) at 90 degrees of knee flexion.