Can Autologous Conditioned Plasma Therapy Enhance Hamstrings Healing After Anterior Cruciate Ligament Reconstruction?

One group receives standard semitendinosus quadruple bundle Anterior Cruciate Ligament Reconstruction (ACLR), while the second group receives similar ACLR combined with Autologous Condition Plasma (ACP) administered to the donor site during surgery. The standard ACLR surgery group is referred to as "ACLR", whereas the group with ACLR combined with ACP is referred to as "ACLR+". For both groups, a quadruple bundle ipsilateral semitendinosus autograft is performed using an anteromedial portal technique. This is a standard surgical procedure to treat ACL deficiency and takes approximately 45 minutes. In the ACLR+ group, the surgical procedure will be augmented by application of Arthrex’ ACP therapy to the donor site and repairing the Sartorius fascia after harvest. The orthopaedic surgeon administers the ACP. For the ACP therapy, 10ml of the patient's own venous blood is aspirated and the syringe centrifuged in a proprietary closed unit (Arthrex Medical Company) for 5 minutes. The red blood cells are discarded, and the supernatant containing ACP (with additional CaCl to activate the ACP) is deposited onto the tendon excision site from pes anserinus to proximal terminus of excision. No adverse consequences are anticipated by using the ACP therapy. Following surgery, all patients will be enrolled in a standardized physiotherapy program and will continue this treatment until completion (~6-9 months clinical recommendation). In the first month, participants will attend their own physiotherapist clinic for a minimum of two one-on-one sessions per week, with each session lasting one hour. For the remaining rehabilitation, participants are required to visit their physiotherapist at least once every two weeks for one hour. During this time, participants are expected to complete their physiotherapy exercises outside of the clinic and visit the physiotherapist for re-assessment. The goal of the rehabilitation and exercises will vary depending on time after surgery. The first month of rehabilitation will involve restoring range of motion to the knee joint and strengthening of hamstring and quadriceps muscles (e.g., cycling). Months 2-3 include closed chain knee strengthening exercises (e.g., leg press) and isometric strengthening. The remaining rehabilitation will aim to restore balance through isokinetic and proprioception exercises, and eventually progress to functional movements such as running and jumping. In each phase, progression will be added by increasing resistance, increasing task complexity, and reducing stability. Adherence will be monitored for both groups through an electronic questionnaire.