Scull Grant, Fisher Matthew B, Brown Ashley C
Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Raleigh, NC 27695.
Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27695.
Med Devices Sens. 2021 Feb;4(1). doi: 10.1002/mds3.10147. Epub 2020 Nov 11.
Anterior cruciate ligament (ACL) tears are a common and potentially career-ending injury, particularly for athletes and soldiers. Partial and complete ruptures of this ligament cause instability in the knee, and the ACL does not have the capacity for healing due, in part, to its position within the highly thrombolytic synovial fluid environment of the knee joint. Traditional methods of ACL reconstruction, such as graft replacement with attached bone anchors for bone integration, restore stability, but do not prevent the development of post-traumatic osteoarthritis. To enhance therapeutic treatment options, novel fibrin-based technologies and repair techniques have been recently explored and show promise for improved patient outcomes. Through modification of existing surgical methods, such as the use of fibrin glues incorporating growth factors and cells and the implementation of scaffolds containing platelet-rich plasma, platelet-rich fibrin, and other blood derivatives, surgeons are attempting to overcome the shortcomings of traditional treatments. This mini-review will detail current efforts using fibrin-based treatments and discuss opportunities to further enhance ACL healing.
前交叉韧带（ACL）撕裂是一种常见且可能终结职业生涯的损伤，尤其是对运动员和士兵而言。该韧带的部分和完全断裂会导致膝关节不稳定，而且ACL部分由于其处于膝关节高度溶栓的滑液环境中，自身没有愈合能力。传统的ACL重建方法，比如用附着骨锚进行骨整合的移植物置换，能恢复稳定性，但无法预防创伤后骨关节炎的发展。为了增加治疗选择，最近人们探索了新型基于纤维蛋白的技术和修复技术，这些技术有望改善患者预后。通过改进现有手术方法，比如使用含有生长因子和细胞的纤维蛋白胶以及采用含有富血小板血浆、富血小板纤维蛋白和其他血液衍生物的支架，外科医生正试图克服传统治疗方法的缺点。本综述将详细介绍目前使用基于纤维蛋白的治疗方法所做的努力，并讨论进一步促进ACL愈合的机会。
