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Bone-Albumin filling decreases donor site morbidity and enhances bone formation after anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts

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Abstract

Purpose

Donor site pain affects 32–43 % of patients after anterior cruciate ligament surgery when the autograft is freshly harvested bone-patellar tendon-bone tissue. Our aim was to compare functional and morphological differences between donor sites with and without serum albumin-coated bone allograft filling.

Methods

After harvesting and implanting the graft, the tibia site was filled with either fresh autologous cancellous bone enhanced with albumin-coated allograft or autologous bone alone. The patella site was filled either with albumin-coated allograft or with blood clot. Knee function was evaluated by the VISA, Lysholm and IKDC scores and a visual analog scale of pain during standing, kneeling and crouching after six weeks and six months. Computed tomography was performed at six months for morphological evaluation.

Results

At six weeks, both groups were still recovering from surgery and the overall knee function was still impaired but the functional scores were significantly higher in the Bone-Albumin group. The pain with crouching and kneeling was also lower as compared to controls. At six months, the knee function scores were close to normal, with a slight decrease in the controls. Pain at kneeling was still prominent in the controls, but significantly lower in the Bone-Albumin group. Computed tomography showed significantly smaller bone defects and higher bone density in the Bone-Albumin group.

Conclusions

Results from the present study indicate that donor site pain, a disturbing long-term side effect of bone-patellar tendon-bone surgery, is significantly reduced if bone buildup in the patella and the tibia is augmented by serum albumin-coated bone allografts.

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Acknowledgments

This study was supported by a research sponsorship grant of OrthoSera GmbH to Semmelweis University.

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Authors and Affiliations

  1. Institute of Clinical Experimental Research, Semmelweis University, Budapest, Tűzoltó u. 37-47, 1094, Hungary

    Károly Schandl, Dénes B. Horváthy, Charlotte M. Schwarz & Zsombor Lacza

  2. Saint George University Teaching Hospital of County-Fejér, Székesfehérvár, Seregélyesi u. 3., 8000, Hungary

    Károly Schandl, Ernő Majzik, Géza Abkarovits & László Bucsi

  3. Department of Transplantation and Surgery, Semmelweis University, Budapest, Baross u. 23-26, 1082, Hungary

    Attila Doros

  4. West Hungarian Regional Tissue Bank, Petz Aladár County Hospital, Győr, Vasvári Pál u. 2-4, 9024, Hungary

    Lajos Csönge

Authors
  1. Károly Schandl
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  2. Dénes B. Horváthy
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  3. Attila Doros
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  4. Ernő Majzik
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  7. Géza Abkarovits
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  8. László Bucsi
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  9. Zsombor Lacza
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Corresponding author

Correspondence to Zsombor Lacza.

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Conflict of interest

ZL declares conflict of interest as the funder and CEO of the start-up company OrthoSera GmbH, which holds a patent for Bone-Albumin.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (ALLO-2013-02).

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Schandl, K., Horváthy, D.B., Doros, A. et al. Bone-Albumin filling decreases donor site morbidity and enhances bone formation after anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts. International Orthopaedics (SICOT) 40, 2097–2104 (2016). https://doi.org/10.1007/s00264-016-3246-8

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  • DOI: https://doi.org/10.1007/s00264-016-3246-8

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