Bone Marrow Aspirate Concentrate Augmentation may Accelerate Allograft Ligamentization in Anterior Cruciate Ligament Reconstruction: A Double Blinded Randomized Controlled Trial
Abstract
PURPOSE
To assess the effect of bone marrow aspiration concentrate (BMAC) augmentation on clinical outcomes and MRI findings in anterior cruciate ligament reconstruction (ACLR) with bone-patellar tendon-bone (BTB) allografts.
METHODS
A double-blinded, randomized controlled trial was conducted on 80 patients undergoing ACLR using BTB allografts. Patients were randomized to two groups: 1) bone marrow aspirate (BMA) was collected from the iliac crest, concentrated, and approximately 2.5 ml was injected into the BTB allograft, or 2) a small sham incision was made at the iliac crest (control). Magnetic resonance imaging (MRI) was performed at 3 months and 9 months post-operatively to determine the signal intensity ratio (SIR) of the anterior cruciate ligament (ACL) graft.
RESULTS
Seventy-three patients were available for follow-up at 1 year post-operatively (36 BMAC, 37 control). IKDC scores were significantly higher in the BMAC group versus the control at the nine-month post-operative period (81.6±10.5 vs 74.6±14.2, p=0.048). There was no significant difference in the proportion of patients who met the minimal clinically important difference (MCID) for IKDC between the BMAC and control groups at 9 months (89% vs. 85%; p=0.7). Three months post-operatively, SIR of the inferior third of the ACL graft was significantly higher in the BMAC group versus the control group (3.2±2.2 vs 2.1±1.5; p=0.02).
CONCLUSION
Patients who received BMAC augmentation of the BTB allograft during ALCR…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 80 participants or records.
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