Gulotta Lawrence V, Kovacevic David, Ying Liang, Ehteshami John R, Montgomery Scott, Rodeo Scott A
Laboratory for Soft Tissue Research, Hospital for Special Surgery, New York, New York 10021, USA.
Am J Sports Med. 2008 Jul;36(7):1290-7. doi: 10.1177/0363546508314396. Epub 2008 Mar 4.
Healing of an anterior cruciate ligament graft in a bone tunnel occurs by formation of fibrous scar tissue, which is weaker than the normal fibrocartilaginous insertion.
We hypothesized that a magnesium-based bone adhesive would improve tendon-to-bone healing in a rabbit anterior cruciate ligament reconstruction model.
Controlled laboratory study.
Thirty-five New Zealand White rabbits underwent bilateral anterior cruciate ligament reconstructions with semitendinosus autografts. A total of 12.5 g of bone adhesive was placed in the intraosseous tunnel around the graft in one limb, while the tunnels in the contralateral limb received no implant. Sixteen animals each were sacrificed at 3 weeks and at 6 weeks (12 biomechanical testing/4 histology). Outcomes included semiquantitative histologic analyses for new cartilage formation and fibrous tissue formation in the tendon-bone interface, microcomputed tomography to quantify new bone formation along the bone tunnel, and biomechanical testing of load-to-failure and stiffness. Three animals were sacrificed at time 0 to confirm adequate tunnel fill with the bone adhesive on microcomputed tomography.
All specimens had adequate tunnel fill with the bone adhesive at time 0. Application of the bone adhesive resulted in more cartilage formation and less fibrous tissue formation at the tendon-bone interface at 6 weeks compared with controls (P < .05). There was significantly more bone formation in the tibia of the treated limbs at 6 weeks (P = .01). The load-to-failure was significantly higher in the treated group at 6 weeks (71.8 +/- 31.8 N vs 43.4 +/- 14.8 N; P = .04). There were no differences in stiffness at either time point, and there were no differences at 3 weeks in any outcome variable.
The magnesium-based bone adhesive improves tendon-to-bone healing based on histologic and biomechanical testing at 6 weeks in a rabbit model of anterior cruciate ligament reconstruction.
Further studies are needed to investigate the clinical potential of this bone adhesive to enhance healing and decrease recovery time in soft-tissue ligament reconstruction.
骨隧道内前交叉韧带移植物的愈合是通过纤维瘢痕组织的形成来实现的，该组织比正常的纤维软骨附着处更脆弱。
我们假设一种镁基骨粘合剂能改善兔前交叉韧带重建模型中的腱骨愈合。
对照实验室研究。
35只新西兰白兔接受了双侧半腱肌自体移植前交叉韧带重建手术。在一侧肢体的移植物周围的骨隧道内放置总共12.5克骨粘合剂，而对侧肢体的隧道不植入任何东西。分别在3周和6周处死16只动物（12只用于生物力学测试/4只用于组织学检查）。结果包括对腱骨界面处新软骨形成和纤维组织形成的半定量组织学分析、用于量化沿骨隧道新骨形成的微型计算机断层扫描，以及对失效载荷和刚度的生物力学测试。在时间0处死3只动物，以通过微型计算机断层扫描确认骨隧道被骨粘合剂充分填充。
所有标本在时间0时骨隧道均被骨粘合剂充分填充。与对照组相比，在6周时应用骨粘合剂导致腱骨界面处有更多的软骨形成和更少的纤维组织形成（P < 0.05）。在6周时，治疗侧肢体胫骨中的骨形成明显更多（P = 0.01）。在6周时，治疗组的失效载荷明显更高（71.8 ± 31.8 N对43.4 ± 14.8 N；P = 0.04）。在两个时间点的刚度均无差异，在3周时任何结果变量也无差异。
在兔前交叉韧带重建模型中，基于6周时的组织学和生物力学测试，镁基骨粘合剂可改善腱骨愈合。
需要进一步研究来调查这种骨粘合剂在软组织韧带重建中增强愈合和缩短恢复时间的临床潜力。
