There is ambiguous recent evidence regarding the use of healing adjuvants during anterior cruciate ligament reconstructions (ACL-R) procedures. Bone marrow aspiration concentrate (BMAC) has been proposed as a safe and potentially healing stimulation aid in animal models; however, clinical evidence is still scarce and controversial regarding imaging and functional results.
Evaluate the imaging and functional outcomes of BMAC augmentation in ACL-R.
Cohort nonrandomized study in patients treated for primary ACL rupture using an autologous hamstring graft. Patients with multiligamentary knee injuries and revision surgeries were excluded. Two study groups were analyzed: Intervention (BMAC) and Control. Both groups were compared for operative times, graft maturation (magnetic resonance at 6 months from surgery), and functional outcomes (isokinetic tests at 6 months from surgery, and KOOS, IKDC, Lysholm, and Tegner at 0, 6, 12, and 30 months). BMAC was obtained from the intercondylar femoral notch during the reconstruction procedure.
Forty-nine patients were selected (30 Intervention/19 Control). Both groups were comparable for age (p=0.845), sex (p=0.711), body mass index (p=0.121), and all pre-operative functional scores, except for a higher KOOS (Function in sport and recreation) in the Control group (p=0.035). Two (6.67%) and two (10.5%) patients from Intervention and Control group, respectively, lost follow-up at 30 months from surgery (p=0.548).
Operative times: The Intervention group showed significantly higher operative times than the Control group [63 minutes (48-90)/50 minutes (38-72); p<0.001].
Graft maturation: No differences regarding graft maturation were observed for tunnel integration (p=0.498; p=0.954) and graft ligamentization (p=0.582) between groups.
Isokinetic tests: No differences between groups in muscle deficit at 6 months, for both extensor [36% (11-68)/ 32% (15-73); p=0.339] and flexor muscles [15% (2-46)/14% (7-34); p=0.875].
Functional scores: No differences at 6, 12, and 30 months from surgery between groups. Both groups showed significant improvements between baseline and 6 months (p<0.001), and between 6 and 12 months (p<0.001).
BMAC did not improve ACL-R graft maturation and isokinetic tests at 6 months of follow-up, nor functional outcomes at 6, 12, and 30 months from surgery compared to a Control group; however, it increased operative time.