The ECM scaffolds (MIACH, Boston Children's Hospital, Boston MA) were manufactured by producing a slurry of ECM proteins from bovine connective tissue as previously reported [30 (link)]. The ECM scaffold was molded into a porous hollow cylinder with an outer diameter of 22 mm, inner diameter of 10 mm, and length of 30 mm [11 (link)]. Once the scaffold was implanted in the knee, it was activated by the addition of platelet-rich plasma at one of three concentrations; 1, 3 and 5 times the pre-operative systematic platelet count (1X, 3X and 5X, respectively). The platelet-rich plasma was created by centrifuging autologous blood as previously described [11 (link)]. The systemic platelet count and final platelet concentrations of platelet-rich plasma were determined using a VetScan HM2 Analyzer (Abaxis, Union City, California).