Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 5, pp 675–683 | Cite as

Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures

  • Matthias Koch
  • Berardo Di Matteo
  • Jürgen Eichhorn
  • Johannes Zellner
  • Felix Mayr
  • Werner Krutsch
  • Leonard Achenbach
  • Rebecca Woehl
  • Michael Nerlich
  • Peter Angele
Arthroscopy and Sports Medicine



Conservative treatment of partial ACL ruptures is associated with a high failure rate, and often patients undergo ACL reconstruction. ACL preservation by trephination of the ACL origin and application of Autologous Conditioned Plasma (ACP) seems to be an intriguing new treatment option to favour ACL tissue healing and avoid traditional reconstruction. The aim of this study was to describe the mid-term outcomes of this new ACL preserving technique.

Materials and methods

Twenty-four patients (mean age 41.8 years) affected by partial rupture of one or both ACL bundles were included in the present trial. The partial ACL tears were arthroscopically assessed and classified according to a new five step grading system. All patients were treated by trephination of the femoral ACL stump and intra-ligamentary application of ACP. The postoperative outcome was evaluated by both subjective scores and stability testing up to a mean of 25.1 months’ follow-up. Adverse events and failure rate were also documented.


Clinical outcome was good to excellent with IKDC subjective 82.7 (SD 11.8), Lysholm 87.6 (SD 8.1), Tegner 5.3 (SD 2.1), Cincinnati 88.7 (SD 14.8). The failure rate (i.e. persisting knee instability assessed clinically or by rolimeter) was 12.5%. At objective measurements, knee joints showed a firm endpoint in Lachman test, negative pivot shift phenomenon and a significant reduction in AP-laxity compared to pre-operative status by rolimeter testing (p = 0.002). Return to sport practice was achieved after mean 4.8 months (SD 4.1).


ACL stump trephination and concomitant intra-ligamentary application of ACP revealed promising results at mid-term follow-up to treat partial ACL lesions.


Knee Partial ACL rupture Autologous conditioned plasma ACP Preservation technique 



The authors thank A. Eichhorn for their technical assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they received support from Arthrex for this study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Matthias Koch
    • 1
  • Berardo Di Matteo
    • 3
  • Jürgen Eichhorn
    • 2
  • Johannes Zellner
    • 1
  • Felix Mayr
    • 1
  • Werner Krutsch
    • 1
  • Leonard Achenbach
    • 1
  • Rebecca Woehl
    • 1
  • Michael Nerlich
    • 1
  • Peter Angele
    • 1
    • 2
  1. 1.Department of Trauma SurgeryUniversity Medical Centre RegensburgRegensburgGermany
  2. 2.Sporthopaedicum Straubing, RegensburgRegensburgGermany
  3. 3.Center for Biological and Functional Reconstruction of the KneeHumanitas Research and University HospitalRozzanoItaly

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