Surgical & Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Randwick, NS NSW 2031, Australia.
Am J Sports Med. 2012 Oct;40(10):2365-74. doi: 10.1177/0363546512457648. Epub 2012 Sep 14.
Techniques to improve and accelerate tendon-bone healing could be advantageous in anterior cruciate ligament (ACL) reconstruction. Effects of demineralized bone matrix (DBM) on intra-articular tendon-bone healing have not been examined.
Demineralized bone matrix has the potential to convey osteoinductive growth proteins to the site of healing at the tendon-bone interface. We hypothesized that the presence of DBM will result in more bone formation and hasten tendon-bone healing.
Controlled laboratory study.
Fifty-six female athymic rnu/rnu (nude) rats were used. Rats were randomly allocated into 2 groups (control or treatment). The control group underwent an ACL reconstruction, while the treatment group had human DBM implanted in the tendon graft and bone tunnel before reconstruction. Rats were sacrificed at 2 (n = 8), 4 (n = 24), and 6 (n = 24) weeks for histological, and immunohistochemical (t = 2, 4, and 6 weeks), and biomechanical testing and micro-computed tomography (t = 4 and 6 weeks) end points.
Our findings suggest that in the presence of DBM, tendon-bone healing is augmented by increased woven bone formation and enhanced bone remodeling as indicated by histology and micro-computed tomography. This ultimately resulted in a statistically significant increase in peak load to failure of the tendon-bone interface at 4 weeks (DBM group: 5.96 ± 1.36 N; control group: 2.86 ± 0.7 N) and 6 weeks (DBM group: 9.13 ± 0.97 N; control group: 5.81 ± 1.1 N).
Demineralized bone matrix at the tendon-bone interface promotes healing between the tendon and bone in a rodent ACL model.
Introduction of osteoinductive DBM at the tendon-bone interface during ACL reconstructive surgery may improve short-term outcomes.
改善和加速肌腱-骨愈合的技术在前交叉韧带（ACL）重建中可能是有利的。脱矿骨基质（DBM）对关节内肌腱-骨愈合的影响尚未被研究。
脱矿骨基质有可能将成骨诱导生长蛋白传递到肌腱-骨界面的愈合部位。我们假设 DBM 的存在将导致更多的骨形成并加速肌腱-骨愈合。
对照实验室研究。
使用 56 只雌性无胸腺 rnu/rnu（裸鼠）。大鼠随机分为 2 组（对照组或治疗组）。对照组行 ACL 重建，而治疗组在重建前将人 DBM 植入肌腱移植物和骨隧道中。2（n = 8）、4（n = 24）和 6（n = 24）周时，进行组织学、免疫组织化学（t = 2、4 和 6 周）和生物力学测试及微计算机断层扫描（t = 4 和 6 周）终点。
我们的研究结果表明，在 DBM 的存在下，肌腱-骨愈合通过增加编织骨形成和增强骨重塑得到增强，这通过组织学和微计算机断层扫描得到证实。这最终导致 4 周（DBM 组：5.96 ± 1.36 N；对照组：2.86 ± 0.7 N）和 6 周（DBM 组：9.13 ± 0.97 N；对照组：5.81 ± 1.1 N）时肌腱-骨界面的失效峰值负荷有统计学显著增加。
在 ACL 模型中，在肌腱-骨界面处使用脱矿骨基质可促进肌腱和骨之间的愈合。
在 ACL 重建手术中，在肌腱-骨界面处引入成骨诱导性 DBM 可能会改善短期结果。
