Tendon-bone healing enhancement using injectable tricalcium phosphate in a dog anterior cruciate ligament reconstruction model
Tendon-bone healing enhancement using injectable tricalcium phosphate in a dog anterior cruciate ligament reconstruction model
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DOI：
10.1016/j.arthro.2006.12.031
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发表时间：
2007-05-01
影响因子：
4.7
通讯作者：
Zhao, Jinzhong
中科院分区：
文献类型：
--
作者：
Huangfu, Xiaoqiao;Zhao, Jinzhong
目的本研究的目的是评估可注射的磷酸三钙（TCP）的前交叉韧带（ACL）重建在狗model.MethodsIn本实验研究中，前交叉韧带重建48只比格犬的双膝与肌腱的趾长屈肌腱骨愈合的促进潜力。采用悬吊固定技术，肌腱移植物仅填充关节附近的隧道部分。在实验侧，除了ACL重建外，还使用可注射TCP填充那些未被移植物填充的隧道部分。在另一侧，不施加额外的处理（对照）。分别于术后2、4、6、8、10、12周处死8只狗，其中3只用于近端腱骨连接处的组织学观察，5只用于力学检查。软骨钙化早于对照侧出现，腱骨愈合快于对照侧。力学测试结果显示，在4周内，实验侧的拔出强度高于对照侧，并且结果之间存在统计学显著性差异.结论在插入ACL移植物后用TCP填充骨隧道导致移植物更快地结合到隧道中，具有更好的生物力学性能和更成熟的组织学模式。临床意义如果这些结果是临床适用的，快速肌腱骨愈合可能是预期在ACL重建。
PurposeThe purpose of this study was to evaluate the enhancement potential of injectable tricalcium phosphate (TCP) for tendon-bone healing in anterior cruciate ligament (ACL) reconstruction in a dog model.MethodsIn this experimental study ACL reconstruction was performed on both knees of 48 beagle dogs with the tendon of the flexor digitorum longus. A suspension fixation technique was used, and the tendon graft filled only the tunnel parts near the joint. On the experimental side, in addition to ACL reconstruction, injectable TCP was used to fill those tunnel parts that were not filled by the graft. On the other side, no additional treatment was applied (control). At 2, 4, 6, 8, 10, and 12 weeks postoperatively, 8 dogs were killed, respectively, with 3 for histologic observation at the proximal tendon-bone junction and 5 for mechanical examination.ResultsHistologic observation showed that on the experimental side, Sharpey fibers, fibrocartilage, and calcified cartilage appear earlier at the tendon-bone interface and tendon-bone healing proceeded more quickly than on the control side. Mechanical examination showed that within 4 weeks, the pullout strength was higher on the experimental side than on the control side, and there was a statistically significant difference between the results.ConclusionsFilling the bone tunnel with TCP after inserting the ACL graft results in faster incorporation of the graft to the tunnel, with better biomechanical properties and a more mature histologic pattern.Clinical RelevanceIf these results are clinically applicable, rapid tendon-bone healing may be expected in ACL reconstruction.