Editorial Commentary: Current Evidence Does Not Support Routine Augmentation of Anterior Cruciate Ligament Reconstruction With Platelet-Rich Plasma, but the Pursuit of Biologic Enhancements to Improve Anterior Cruciate Ligament Surgical Outcomes Should Continue

Platelet-rich plasma (PRP) has been used to augment anterior cruciate ligament (ACL) surgery, with studies reaching conflicting conclusions as to the extent of beneficial effects. Although most ACL surgeries I have performed have not been augmented, I have used PRP (and bone marrow concentrate) enough to conclude that my personal experience matches the literature finding of no significant difference in outcomes, and, at present does not support routine augmentation of ACL reconstruction with PRP. Instead, I believe the "crimson duvet" effect of reaming tunnels is a key source of cells and signals that promote healing and initiate graft incorporation. Our journals must continue to publish important "negative" outcome studies as we continue to pursue more substantially beneficial methods of biologically enhancing ACL surgery.