Abstract
BackgroundCalcium phosphate (CaP)-hybridization of tendon grafts has been shown to improve tendon-to-bone healing. The purpose of this study was to clarify the influence of different tendon graft placement methods on tendon-to-bone healing using CaP-hybridized tendon grafts in anterior cruciate ligament (ACL) reconstructions in rabbits.MethodsWe compared two methods of tendon graft placement within the femoral bone tunnel: suspension of the tendon graft within the bone tunnel (suspension group) and implantation of the tendon graft coherent with the bone socket (coherence group). CaP-hybridized tendon grafts were used in both groups. Fifty-six male Japanese white rabbits were used for this study. The results of biomechanical tests (n = 9) and histological analyses (n = 5) were evaluated at 2 and 4 weeks after surgery.ResultsThe ultimate failure load, stiffness, stress, soft tissue remaining in bone tunnel after biomechanical testing, and direct bonding area at tendon–bone interface did not differ significantly between the suspension and coherence groups at either 2 or 4 weeks after surgery (p > 0.05). In both groups, the ultimate failure load, stress, soft tissue remaining in the bone tunnel, and direct bonding area at interface at 4 weeks after surgery were significantly greater than those at 2 weeks after surgery (p < 0.05).ConclusionsTendon-to-bone healing in both groups progressed until the endpoint of 4 weeks. There was no influence of the CaP-hybridized tendon graft placement method on tendon-to-bone healing at 4 weeks after ACL reconstruction in rabbits. Thus, the CaP-hybridized tendon grafts were unaffected by differences in their placement within the bone tunnel and became equally anchored to the bone tunnel during the early postoperative period. The tendon graft placement method may not influence tendon-to-bone healing in ACL reconstruction when CaP-hybridized tendon grafts are used.
Highlights
Calcium phosphate (CaP)-hybridization of tendon grafts has been shown to improve tendon-to-bone healing
We have previously developed a novel technique to improve tendon-to-bone healing that used an alternating soaking process to hybridize calcium phosphate (CaP) to tendon grafts [1]
The use of our technique prior to tendon graft implantation stimulated osteogenesis, and areas of direct bonding were observed between CaPhybridized tendon grafts and a newly formed bone at 2– 3 weeks after implantation in a rabbit anterior cruciate ligament (ACL) reconstruction model [2, 3]
Summary
Calcium phosphate (CaP)-hybridization of tendon grafts has been shown to improve tendon-to-bone healing. We have previously developed a novel technique to improve tendon-to-bone healing that used an alternating soaking process to hybridize calcium phosphate (CaP) to tendon grafts [1]. The use of our technique prior to tendon graft implantation stimulated osteogenesis, and areas of direct bonding were observed between CaPhybridized tendon grafts and a newly formed bone at 2– 3 weeks after implantation in a rabbit anterior cruciate ligament (ACL) reconstruction model [2, 3]. In a recent clinical trial, use of CaP-hybridized tendon grafts improved anterior knee stability and clinical scores at 2 years after surgery and reduced the percentage of bone tunnel enlargement at 1 year after surgery, relative to the outcomes with untreated tendon grafts during ACL reconstruction [6]
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