Evaluation of the tibial tunnel after intraoperatively administered platelet-rich plasma gel during anterior cruciate ligament reconstruction using diffusion weighted and dynamic contrast-enhanced MRI

Purpose: To evaluate effect of platelet-rich plasma gel (PRPG), locally administered during the anterior cruciate ligament (ACL) reconstruction, with two MRI methods. The proximal tibial tunnel was assessed with diffusion weighted imaging (DWI) and with dynamic contrast-enhanced imaging (DCE-MRI). Materials and Methods: In 50 patients, standard arthroscopic ACL reconstructions were performed. The patients in the PRPG group (n = 25) received a local application of PRPG. The proximal tibial tunnel was examined by DWI and DCE-MRI, which were used to calculate apparent diffusion coefficient (ADC) values, as well as the contrast enhancement gradient (Genh) and enhancement factor (Fenh) values. Results: At 1 month, the calculated average ADC value in the PRPG group was significantly lower than in the control group. At 2.5 and at 6 months, Genh was significantly higher in the PRPG group. There were no significant differences in Fenh between the groups at any control examination. Conclusion: DWI and DCE-MRI measurements indicate a reduced extent of edema during the first postoperative month as well as an increased vascular density and microvessel permeability in the proximal tibial tunnel at 1 and 2.5 postoperative months as the effect of the application of PRPG. J. Magn. Reson. Imaging 2013;37:928935. (c) 2012 Wiley Periodicals, Inc.