Sensory Deficit Following Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Autograft: Platelet-Rich Fibrin (PRF) Could Provide a Solution

采用骨-髌腱-骨自体移植进行前交叉韧带重建术后感觉障碍:富血小板纤维蛋白(PRF)或可提供解决方案

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Abstract

Background and Objectives: Despite the high rate of donor site morbidity, a bone-patellar tendon-bone (BPTB) graft remains the gold standard when choosing a graft for anterior cruciate ligament (ACL) reconstruction. Damage to the infrapatellar branch of the saphenous nerve (IPBSN) during graft harvesting results in sensory deficits. Despite its high occurrence in the postoperative period, many patients go untreated, leading to a lower quality of life and potential professional impairment. The aim of this study was to assess the effectiveness of PRF therapy in alleviating sensory deficits and enhancing sensory nerve function in patients who have undergone BTB ACL reconstruction. Materials and Methods: This study was registered at ClinicalTrials.gov (Name of registry: ClinicalTrials.gov; Trial registration number: NCT07257666; Date of registration: 2 December 2025; Study start date: 7 January 2022). Over a one-year period, the pilot study enrolled 53 patients, treated them with BPTB ACL reconstruction, and divided them into two groups. The testing group's donor site and subcutaneous tissue were treated with Vivostat(®) PRF, whereas the standard group's donor site and subcutaneous tissue remained untreated. The primary outcome measured was a reduction in the subjective numbness, which was tested during follow-up checks. Secondary outcomes included the evaluation of subjective knee scores for functional recovery, reported by the patients on control exams. Results: The use of Vivostat(®) PRF resulted in a statistically significant reduction in sensory deficit among the groups at eight months (p < 0.05) and twelve months (p < 0.01) following surgery, favoring the testing group. The most substantial decrease in symptomatic patients was observed between four and eight months post-surgery, with no statistically significant difference found between the eight- and twelve-month follow-ups (p > 0.05). Evaluations of subjective knee function and activity scores showed no statistically significant differences between the groups. Conclusions: Using Vivostat(®) PRF helps reduce sensory impairment in the area and minimizes donor site morbidity after BPTB ACL reconstruction.

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