Use of growth factors in ACL surgery: preliminary study

There is no general con- sensus on the use of growth factors (GF) in surgery. The aim of this study was to clarify if GF play a role in anterior cruciate ligament (ACL) surgery. Twenty patients with laxity caused by a torn ACL underwent arthroscopically assisted reconstruction with autologous hamstring tendons. We performed a prospective study with these patients randomized into 2 groups: GF-treated and control. Growth fac- tors were obtained according to the GPS Biomet-Merck technique and are applied to femoral and tibial tunnels during surgical procedure. Patients were evaluated clinically and functionally. Computed tomo- graphy (CT) of the knee was per- formed in all the patients; a limited number of patients underwent magnetic resonance imaging (MRI). There were no significant differen- ces concerning KOOS, IKDC, KT- 1000, Tegner score rating and clini- cal examination between the two groups 6 months after ACL surgery. CT highlighted a significant diffe- rence (p<0.01) between ACL den- sity of the two groups and showed that ACL density was similar to that of the posterior cruciate liga- ment in GF-treated group. In this group, however, one patient had a synovitic reaction: the new ACL was increased, hypertrophic and surrounded by a reaction of soft tis- sues. GF may accelerate the inte- gration of the new ACL in the femoral and tibial tunnels, but fur- ther clinical studies are necessary to better understand the mechanism of action of GF, widely studied only in vitro and in animal models.