Abstract
BackgroundThe purpose of this study was to test effects of negative pressure on tendon–bone healing after reconstruction of anterior cruciate ligament (ACL) in rabbits.MethodsHind legs of 24 New Zealand White rabbits were randomly selected as negative pressure group and the contralateral hind legs as control. Reconstruction of the ACL was done. Joints of the negative pressure side were placed with drainage tubes connecting the micro-negative pressure aspirator. Control side was placed with ordinary drainage tubes. Drainage tubes on both sides were removed at the same time 5 days after operation. After 6 weeks, joint fluid was drawn to detect the expression levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α); at the same time, femur–ligament–tibia complex was obtained to determine tendon graft tension and to observe the histomorphology, blood vessels of the tendon–bone interface, and expression of vascular endothelial growth factor (VEGF).ResultsThe maximum load breakage of tendon graft was significantly greater in the negative pressure group than in the control group (P < 0.05). Histological studies of the tendon–bone interface found that there was more new bone formation containing chondroid cells and aligned connective tissue in the negative pressure group than in the control group. Expression of VEGF was higher in the negative pressure group than in the control group (P < 0.01). Content of IL-1β and TNF-α in synovial fluid is lower in the negative pressure group than in the control group (P < 0.01).ConclusionsIntermittent negative pressure plays an active role in tendon–bone healing and creeping substitution of ACL reconstruction in the rabbits.
Highlights
The purpose of this study was to test effects of negative pressure on tendon–bone healing after reconstruction of anterior cruciate ligament (ACL) in rabbits
Tensile results showed that the force of complete rupture or pulled out from the bone tunnels was significantly higher in the negative pressure group than in the control group (P < 0.05, Table 1)
The tendon–bone interface had a lot of vascular distribution in the negative pressure group (Fig. 2a), but vascular structure on the tendon– bone interface was sparse in the control group (Fig. 2b)
Summary
The purpose of this study was to test effects of negative pressure on tendon–bone healing after reconstruction of anterior cruciate ligament (ACL) in rabbits. Anterior cruciate ligament (ACL) reconstruction using soft tissue autograft in bone tunnel has become popular in the past 10 years [1,2,3]. Tendon–bone healing of the graft at the bone tunnel is a main concern when using a tendon graft for ACL reconstruction. Because tendon graft and host bone tunnel are two types of tissue, tendon–bone incorporation is complex and slow. The causes of ACL reconstruction failure mainly include technical errors, biological failure, and traumatic injury. Surgical technique-related errors are the most common cause of relapsing instability after ACL reconstruction, accounting for 77 to 95% of all cases of ACL failure [6]. It is important to stimulate biological healing between the graft and bone tunnel for functional exercises, sports, and daily activities as early as possible
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