Applications of ACP* in knee surgery Surgical Technique * ACP - Autologous Conditioned Plasma

Introduction Autologous blood products like blood plasma have created a growing interest for use in a number of orthopaedic therapies. The healing effects of plasma are supported by growth factors released by platelets. The ACP (Autologous Conditioned Plasma) Double Syringe System is used for sterile separation of non-homogenous liquids. This device will allow the withdraw of blood from the human body using a commercial available cannula with LuerLock connection. Mechanism of ACP If blood is prepared in the form described, the plasma contains a 2 - 3 fold platelet concentration over baseline.7...

Surgical Technique Partial rupture of the anterior cruciate ligament 9 Treatment of partial ruptures Levels 1 - 3 (up to Level 4 for older, but active patients) of the anterior cruciate ligament following prior arthroscopic evaluation. The procedure can be used for acute and for chronic injuries that have not responded sufficiently to the treatment. A side-to-side difference of a maximum of 3 mm in the KT1000 test, negative pivot shift, maximum indicated pivot glide and subjective stability are considered as a positive response to treatment. 1 First, puncture the proximal stump with a cannula...

3 For Level 3 and 4, use a small chisel (approx. 3 mm) to fold a thin osseous flake from the roof of the fossa intercondylaris into the remainder of the anterior cruciate ligament. 4 Insert one cannula into the proximal attachment of the partially ruptured anterior cruciate ligament and another into the median compartment, drain off the irrigation solution and remove the arthroscope. Post-treatment protocol Up to 2 weeks post-op • Mecron brace 20° • Partial weight bearing 10 kg • Passive range of Motion (ROM): 0 °/ 20 °/ 60° Weeks 3 - 6 • Functional leg brace during the day 0° / 10 °/ 90° • Mecron...

Surgical Technique Partial rupture of the medial collateral ligament (MCL) For partial ruptures that do not involve any surgical treatment, inject ACP conservatively into the rupture site, which has been identified using magnetic resonance imaging (perform depot injections at several sites) and repeat after two weeks. Support the procedure using functional movement-limiting therapy / a knee brace. Healing response for elongated MCL – surgical treatment option 9 For a healed collateral ligament (diagnosis during anterior cruciate ligament reconstruction) with (clinically relevant) laxicity. 1...

Withdraw the Langenbeck hook. Use the ClawInstrument to perforate the collateral ligament (coronary ligaments, capsular lining) from outside through the collateral ligament into the periosteum (microperforation technique in line with Rosenberg): Firstly from proximal to distal 1 , then from proximal to dorsal 2 and from dorsal to ventral 3 . 5 Finally, inject the ACP into the collateral ligament (perform depot injections at several sites). Repeat the injection post-op conservatively after two weeks and four weeks.

Surgical Technique Healing support to the repair of the isolated meniscal tear Torpedo shaver Meniscus Repair Rasp 1 Refresh the meniscal edge around the injury intensively with a small joint or Torpedo shaver, with a sharp 1.6 mm Guidewire and a Meniscus Repair Rasp. 2 Use a PowerPick to make 5 - 6 holes in the Fossa intercondylaris slightly outside the attachment area of the Posterior cruciate ligament. 3 After suturing the meniscus, insert one cannula into the suture site and one into the meniscus rim (close to the capsule) and, after draining off the irrigation solution and removing the arthroscope,...

Ordering information Arthrex ACP Double Syringe ABS-10014 Centrifuge Hettich Rotofix 32 with Swing Out Rotor 1324, 220 V 1206-Art Centrifuge Hettich Rotofix 32 with Swing Out Rotor 1324, 110 V 1206-01-Art Bucket with Screw Cap for Centrifuge (spare) ABS-10022 ArthrexACP counterweight for centrifugation of ACP Double Syringe, 15ml ABS-10027 Meniscus Repair Rasp AR-4130 Guidewire, Ankle Arthroscopy, 1.6 mm AR-8655K-16 An anticoagulant can be ordered on request. 1. Borzini P, Mazzucco L: Tissue Regeneration and in Loco Administration of Platelet Derivates: Clinical Outcomes, Heterogeneous Products,...