Suture Augmentation Does Not Change Biomechanical Properties and Histological Remodeling of Tendon Graft in Anterior Cruciate Ligament Reconstruction: A Study in a Porcine Model
Suture Augmentation Does Not Change Biomechanical Properties and Histological Remodeling of Tendon Graft in Anterior Cruciate Ligament Reconstruction: A Study in a Porcine Model
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DOI：
10.1016/j.arthro.2022.10.049
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发表时间：
2023-03-03
影响因子：
4.7
通讯作者：
Takahashi, Jun
中科院分区：
文献类型：
--
作者：
Iwaasa, Tomoya;Takahashi, Tsuneari;Takahashi, Jun
目的：评价超高相对分子质量聚乙烯(UHMWPE)缝线联合应用于猪前交叉韧带(ACL)重建模型的初步安全性，以及该方法是否会影响膝关节前松弛程度和肌腱本身的结构特性，影响组织学重建，并引起异物性炎症。方法：将10只猪分为SA组和非SA组，分别采用自体半腱肌腱和不加SA重建前交叉韧带。术后12周取下胫骨内固定的移植物肌腱和前交叉韧带，对移植物肌腱的膝关节前松弛程度和结构特点进行力学测试。结果：前向松弛SA组为1.19±-0.78 mm，非SA组为1.08±0.42 mm，两组间差异无统计学意义(P=1)。两组在最大载荷失效、屈服强度、刚度、断裂伸长率和LTMI评分方面无显著差异(P值分别为0.31、1、1、1和0.24)。所有移植肌腱均未出现异物反应。结论：缝线扩张术对膝关节前松弛及移植肌腱的结构特性无明显影响，对组织学重建无明显影响，也未引起异物反应。临床意义：本研究结果可为进一步的临床研究奠定基础，以验证SA重建前交叉韧带的有效性。
Purpose: To evaluate the initial safety of the combined use of ultra-high molecular weight polyethylene (UHMWPE) sutures for suture augmentation (SA) in a porcine ACL reconstruction model and examine whether the procedure can affect the anterior knee laxity and structural properties of the tendon graft itself, influence histological remodeling, and cause a foreign body-induced inflammation.Methods: Ten pigs were divided into SA and non-SA Groups to undergo ACL reconstruction using an autologous semitendinosus tendon with and without SA, respectively. At 12 weeks post-operatively, the tibial fixation of the grafted tendon and SA was removed, and the anterior knee laxity and structural characteristics of the grafted tendon were evaluated for mechanical testing. Histological evaluation, including the ligament tissue maturation index (LTMI) score and the presence or absence of foreign-body reaction, was evaluated.Results: There was no significant difference in anterior laxity between the two groups (SA Group, 1.19 +/- 0.78 mm; non -SA Group, 1.08 +/- 0.42 mm; P = 1). There were no significant differences in maximum load failure, yield strength, stiffness, elongation at failure, and the LTMI score between the two groups (P = 0.31, 1, 1, 1, and 0.24, respectively). All grafted tendons showed no foreign-body reactions. Conclusion: Suture augmentation did not have significant effect on the anterior knee laxity and the structural properties of the grafted tendon, interfere with histological remodeling, or cause foreign body-induced reactions.Clinical Relevance: The results of our study may lay the foundation for further clinical studies to verify the usefulness of ACL reconstruction with SA.