Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan.
Biomechanics Laboratory, Faculty of System Design, Tokyo Metropolitan University, Tokyo, Japan.
Orthop J Sports Med. 2016 Aug 23;4(8):2325967116662653. doi: 10.1177/2325967116662653. eCollection 2016 Aug.
We previously developed a novel technique using an alternate soaking process that improves tendon-bone healing by hybridizing the tendon graft with calcium phosphate (CaP). However, the effects of the CaP-hybridized tendon graft on anatomic single-bundle anterior cruciate ligament (ACL) reconstruction remain unclear.
To determine the effects of CaP-hybridized tendon grafts compared with untreated tendon grafts 6 months after anatomic single-bundle ACL reconstruction using a goat model.
Controlled laboratory study.
Animals were divided into a CaP group (n = 5 goats) and a control group (n = 5 goats), and we analyzed (1) knee kinematics and in situ forces under applied anterior tibial loads of 50 N and internal tibial torque of 2.0 N·m in the grafts at full extension and at 60° and 90° of knee flexion, (2) the mean percentage of bone tunnel enlargement using computed tomography (CT), and (3) the histology of the tendon-bone interface.
The in situ forces under applied anterior tibial loads of 50 N at 60° and 90° of knee flexion in the CaP group were greater than those in the control group (P < .05). The red safranin-O-stained area, indicating glycosaminoglycans in the cartilage layers at the joint aperture sites of the anterior femoral and posterior tibial bone tunnel, was greater in the CaP group than that in the control group (P < .05). The lengths of the nonbonding gap area between the anterior femoral and posterior tibial bone tunnels in the control group were greater than those in the CaP group (P < .05). No significant difference could be detected in the mean percentage of bone tunnel enlargement between the 2 groups.
The CaP-hybridized tendon graft enhanced tendon-bone healing at the joint aperture site in both anterior femoral and posterior tibial tunnels 6 months after anatomic single-bundle ACL reconstruction in goats. The in situ forces under applied anterior tibial loads at greater flexion angles in the CaP group increased compared with controls.
Anatomic single-bundle ACL reconstruction using CaP-hybridized tendon grafts may lead to better postoperative knee function.
我们之前开发了一种新的技术，使用交替浸泡的方法，通过将肌腱移植物与磷酸钙（CaP）杂交来改善腱骨愈合。然而，CaP 杂交肌腱移植物对解剖学单束前交叉韧带（ACL）重建的影响尚不清楚。
使用山羊模型确定解剖学单束 ACL 重建后 6 个月时，与未处理的肌腱移植物相比，CaP 杂交肌腱移植物的效果。
对照实验室研究。
动物分为 CaP 组（n = 5 只山羊）和对照组（n = 5 只山羊），我们分析了（1）在完全伸展和 60°和 90°膝关节屈曲下，施加 50N 的胫骨前负荷和 2.0N·m 的胫骨内扭矩时，移植物中的膝关节运动学和原位力，（2）使用计算机断层扫描（CT）测量的骨隧道扩大的平均百分比，以及（3）肌腱-骨界面的组织学。
CaP 组在 60°和 90°膝关节屈曲下施加 50N 的胫骨前负荷的原位力大于对照组（P <.05）。关节开口处前股骨和后胫骨骨隧道的软骨层中，红色番红 O 染色区域，代表糖胺聚糖，CaP 组大于对照组（P <.05）。对照组中前股骨和后胫骨骨隧道之间非结合间隙区域的长度大于 CaP 组（P <.05）。两组之间的骨隧道扩大的平均百分比没有显著差异。
山羊解剖学单束 ACL 重建后 6 个月，CaP 杂交肌腱移植物增强了前股骨和后胫骨隧道关节开口处的腱骨愈合。CaP 组在更大的屈曲角度下施加胫骨前负荷的原位力与对照组相比增加。
使用 CaP 杂交肌腱移植物进行解剖学单束 ACL 重建可能会导致术后膝关节功能更好。
