BioACL Repair

00:00:15: Welcome back to Better with Biobits.

00:00:17: I'm Sarah.

00:00:18: And I'm Mark.

00:00:20: Today, we're focusing on one of the most studied applications of biologics in sports medicine, ACL reconstruction, and how outcomes can become better with bio when autologous biologics are added.

00:00:32: ACL reconstruction reliably restores knee stability, especially when using our internal brace.

00:00:39: But graft healing and integration remain critical challenges.

00:00:43: particularly tendon-to-bone healing within the tunnels.

00:00:46: Delayed graft maturation, tunnel-widening inflammation, and prolonged functional recovery can all impact outcomes and delay return to sport.

00:00:55: That's why biologic augmentation, specifically with autologous blood derivatives like PRP using our systems, ACP, ACPmax or ANGEL, has gained significant attention as a way to enhance the biological environment around the graft to avoid complications and to improve outcomes.

00:01:16: The primary biologic adjunct used in ACL reconstruction is platelet-rich plasma, or ACP, which delivers concentrated autologous growth factors that support healing, reduce inflammation, and promote tissue integration.

00:01:31: ACP can be used alone or in combination with the thrombinator.

00:01:35: producing autologous thrombin serum to create a fibrin glue that helps stabilize biologic application if needed.

00:01:42: In some workflows, devices like GraphNet allow surgeons to collect autologous bone debris during tunnel drilling and apply it directly back into the tunnels around the graft, helping create a richer biologic environment that supports stronger graft and growth at the tendon-to-bone interface.

00:02:00: The evidence base here is substantial.

00:02:03: Across sixteen clinical studies, including ten-level-one randomized controlled trials, PRP augmented ACL reconstruction has demonstrated consistent biological and early clinical benefits.

00:02:17: Key findings include tendon-to-bone healing, significant reduction in femoral and tibial tunnel widening, improved graft-to-bone, intake slash gration, graft remodeling, faster and more advanced graft maturation.

00:02:31: Higher vascular density and microvessel permeability.

00:02:35: Up to forty-eight percent earlier, graft homogenization on imaging.

00:02:39: And importantly, these biological augmentations translate into improved measurable clinical outcomes.

00:02:46: Exactly.

00:02:46: Clinical studies report less pain and swelling, reduced inflammatory markers, improved nemobility and stability, faster hamstring strength recovery, and improved symmetry.

00:02:57: Earlier returned to sport and selected cohorts.

00:03:00: Taken together, this supports PRP, like ACP, as a tool not just for imaging outcomes, but for meaningful functional recovery, particularly in the early postoperative phase, setting the foundation for successful healing, protecting the graft or repair from excessive stress, and helping to prevent complications such as stiffness or graft failure.

00:03:24: PRP can be applied at multiple locations and time points, direct graft injection or soaking, bone tunnels, with or without bone graft.

00:03:33: Intraarticular application, pre, intras, or post-operatively.

00:03:37: From a rep perspective, the role is operational.

00:03:40: Supporting proper timing of ACP or thrombinator preparation.

00:03:45: Know the surgeon's preferred treatment options.

00:03:47: Ensuring the biologic step integrates smoothly into the surgical workflow.

00:03:52: Execution matters, especially given the variability in protocols.

00:03:56: Here's the core positioning message.

00:03:58: PRP is a safe, autologous adjunct that enhances graft ingrowth and healing, improves early functional recovery, and supports structural graft integrity and ACL reconstruction.

00:04:10: A common objection is, there's no standardized PRP protocol.

00:04:16: A balanced response.

00:04:18: That's true.

00:04:19: Protocols vary.

00:04:20: However, across multiple application methods, high-level studies show PRP consistently improves graft maturation, tunnel healing, and early recovery.

00:04:30: And with our system's ACP, ACP Max or Angel together with the thrombinator, we can provide easily deliverable, reproducible PRP compositions and proven clinical efficacy.

00:04:44: Important limitations to acknowledge.

00:04:46: No standardized PRP preparation or application protocol.

00:04:50: Variability and injection timing and location.

00:04:53: Many studies have short-term follow-up.

00:04:55: Even so, the strength and consistency of level one evidence support ACP as a valuable biologic adjunct in ACL reconstruction.

00:05:05: That brings us to the end of today's episode of Better with Biobits.

00:05:09: Join us next time as we continue exploring how otologous biologics enhance healing across surgical indications.

00:05:15: Thanks for listening.