Abstract
Patients after anterior cruciate ligament (ACL) reconstruction surgery commonly encounters graft failure in the initial phase of rehabilitation. The inhibition of graft degradation is crucial for the successful reconstruction of the ACL. Here, we used biodegradable high-purity magnesium (HP Mg) screws in the rabbit model of ACL reconstruction with titanium (Ti) screws as a control and analyzed the graft degradation and screw corrosion using direct pull-out tests, microCT scanning, and histological and immunohistochemical staining. The most noteworthy finding was that tendon graft fixed by HP Mg screws exhibited biomechanical properties substantially superior to that by Ti screws and the relative area of collagen fiber at the tendon-bone interface was much larger in the Mg group, when severe graft degradation was identified in the histological analysis at 3 weeks. Semi-quantitative immunohistochemical results further elucidated that the MMP-13 expression significantly decreased surrounding HP Mg screws with relatively higher Collagen II expression. And HP Mg screws exhibited uniform corrosion behavior without displacement or loosening in the femoral tunnel. Therefore, our results demonstrated that Mg screw inhibited graft degradation and improved biomechanical properties of tendon graft during the early phase of graft healing and highlighted its potential in ACL reconstruction.
Highlights
Some cases, and these changes may lead to an antagonistic environment for Anterior cruciate ligament (ACL) reconstruction, which causes the lack of sufficient graft incorporation during the early graft healing phase[13]
The present study identified the potential of Mg interference screws in ACL reconstruction, especially during the initial phase of graft healing
high-purity magnesium (HP Mg) screws provided rigid mechanical strength comparable to traditional Ti screws in the fixation of the tendon graft; the femur-tendon graft-tibia complexes of both groups failed with equal valence at 0 week
Summary
Some cases, and these changes may lead to an antagonistic environment for ACL reconstruction, which causes the lack of sufficient graft incorporation during the early graft healing phase[13]. Magnesium (Mg) materials have recently been the focus of biodegradable implants in musculoskeletal tissues[14]. Mg has mechanical properties that provide rigid fixation of tendon graft and sustain a loading environment[15]. It is essential to determine the influence of biodegradable Mg implants on graft degradation as well as its function in graft fixation during early graft healing process after ACL reconstruction. We hypothesized that the novel interference screw could inhibit graft degradation, promote tendon-bone healing and provide rigid fixation of the tendon graft in the early phase after ACL reconstruction. The influence of Mg screws on graft degradation and the related mechanism was elucidated as well as the corrosion behaviors of Mg screws in the early phase of tendon-graft healing
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