Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA.
Sci Rep. 2024 Nov 9;14(1):27408. doi: 10.1038/s41598-024-75914-z.
Anterior cruciate ligament reconstruction (ACLR) is one of the more common procedures performed worldwide and perhaps the most widely studied construct in orthopedic literature. Interference screws are reliable and frequently used for ligament reconstruction, providing rigid fixation and facilitates graft incorporation allowing for the physiologic loads of early rehabilitation. The purpose of this study was to determine the bio-integration profile and quality of soft tissue graft when using mineral fiber-reinforced screws in an ACLR interference model. Nine sheep underwent ACLR using harvested autologous tendon graft fixated with 4.75 mm screws made of continuous mineral fibers. Histopathology and imaging evaluation at 28, 52, 104, 132-weeks (W) demonstrated mesenchymal tissue ingrowth into implant wall at 28 W, which increased at 52 W and peaked at 104 W. At 132 W, implants fully replaced by newly remodeled bone. Graft cellularity was evident at 28 W and continued to increase through 132 W as the tendon ossified at sites of bone contact. Pro-healing M2-macrophages and giant cells remained infrequent, with minor increases between 52 W and 104 W, attributed to expected phagocytic response. Pro-inflammatory cells (i.e., M1-macrophages, polymorphonuclears) were absent through the entire study course. In conclusion, bio-integrative screws provide secure soft tissue fixation with replacement by bone demonstrating graft cellularization over time.
前交叉韧带重建 (ACLR) 是全球范围内较为常见的手术之一，也是骨科文献中研究最多的构建物之一。干扰螺钉是一种可靠且常用于韧带重建的方法，可提供刚性固定，并促进移植物的整合，从而使早期康复过程中能够承受生理负荷。本研究旨在确定在 ACLR 干扰模型中使用矿物纤维增强螺钉时，软组织移植物的生物整合情况和质量。9 只绵羊接受了 ACLR 手术，使用取自自体肌腱的移植物，用 4.75 毫米的连续矿物纤维制成的螺钉固定。28、52、104 和 132 周（W）的组织病理学和影像学评估显示，28 周时基质组织开始向植入物壁内生长，52 周时增加，104 周时达到峰值。在 132 周时，植入物完全被新改建的骨取代。28 周时可见移植物细胞，随着肌腱在与骨接触的部位骨化，细胞数量持续增加至 132 周。修复性 M2 巨噬细胞和巨细胞仍然很少见，52 周和 104 周之间略有增加，这归因于预期的吞噬反应。整个研究过程中都没有出现前炎症细胞（即 M1 巨噬细胞、多形核细胞）。总之，生物整合螺钉提供了可靠的软组织固定，随着时间的推移，通过骨取代来实现移植物的细胞化。
