Growth factors and platelet rich plasma in anterior cruciate ligament reconstruction

Platelet Rich Plasma (PRP) and growth factors have had encouraging results in several surgical specialties. Their use in orthopaedics is increasing and has been trialed in fracture management, spinal fusion and tendon and ligament healing. Anterior cruciate ligament (ACL) injuries are a significant economic burden and often require surgical reconstruction. This review article used laboratory and clinical studies to evaluate the effectiveness of PRP and growth factors as an adjunct to ACL reconstruction. Overall, the results of studies to date have been disappointing especially given the success in other specialties. PRP has been relatively successful in improving vascularization within the tibial tunnel but less so in the femoral tunnels. The targeting of specific growth factors seems to show more promise than generic PRP injections with vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF) and transforming growth factor-beta (TGF-β) showing the most significant results in graft healing. Further trials are still required before a definitive conclusion can be reached.