Hyperbaric Oxygen Therapy Improves Early Graft Healing Following ACL Reconstruction with Hamstring Autografts
C.B.G. Leite, D. Meirelles, L.R. Morimoto, A.G. Ormond Filho, C.O.D. Elia, M.K. DemangeObjectives:
To evaluate the impact of hyperbaric oxygen therapy on graft maturation and integration in patients undergoing anterior cruciate ligament (ACL) reconstruction, using magnetic resonance imaging (MRI) performed 4 months postoperatively.
Methods:
Patients who underwent primary anatomic ACL reconstruction with hamstring autografts and adjunctive hyperbaric oxygen therapy were identified and matched 1:1 by sex and age categories (<25, 25–39, 40–54, and >55 years) with controls who did not receive hyperbaric oxygen therapy. MRI was performed at 4 months postoperatively. Graft maturation was assessed using the signal-to-noise quotient (SNQ), and bone marrow edema adjacent to the graft–bone tunnel interface was graded as absent, mild, or accentuated as an indirect marker of graft integration.
Results:
A total of 52 patients were included (26 hyperbaric oxygen therapy, 26 controls), with a mean age of 37.0 ± 13.5 years and 61.5% male. The hyperbaric oxygen therapy group demonstrated significantly lower graft SNQ compared with controls (median difference = 83.9; p = 0.031), indicating improved graft maturation. Bone marrow edema adjacent to the graft–bone tunnel interface was also significantly lower in the hyperbaric oxygen therapy group (p = 0.029), suggesting enhanced graft integration.
Conclusion:
Hyperbaric oxygen therapy following ACL reconstruction was associated with significantly improved early signs of graft maturation and integration on MRI at 4 months, suggesting that it may accelerate the early phases of graft healing.