Generation of tendon-to-bone interface "Enthesis" with use of recombinant BMP-2 in a rabbit model
Generation of tendon-to-bone interface "Enthesis" with use of recombinant BMP-2 in a rabbit model
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DOI：
10.1002/jor.20447
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发表时间：
2007-11-01
影响因子：
2.8
通讯作者：
Takaoka, Kunio
中科院分区：
文献类型：
--
作者：
Hashimoto, Yusuke;Yoshida, Gen;Takaoka, Kunio
骨-肌腱和骨-韧带界面处的解剖结构称为附着点。在组织学上，附着点的特征在于从肌腱末端到骨的一系列过渡组织层，包括肌腱、纤维软骨、钙化纤维软骨和骨。这种布置产生软组织与骨的更强的直接连接。在外科修复中，附着点已被证明难以重现，并且韧带-骨结合的成功取决于任何韧带重建后形成的纤维附着。在这项研究中，我们试图产生一个直接插入附着点在两个阶段。首先，将重组人骨形态发生蛋白-2（rhBMP-2）注射到兔后肢的趾总屈肌腱中以诱导异位小骨形成。在第二步中，然后将所得的肌腱/听小骨复合物通过手术转移到兔胫骨的表面上以产生稳定的肌腱-骨连接。术后1个月，组织形态学检查证实肌腱-骨结构直接插入家兔胫骨近端。BMP-2生成的肌腱-骨连接的极限失效载荷显著高于对照组（p < 0.01）。这些结果表明，它是可能成功地再生一个直接肌腱-骨附着点。使用这种方法可以成功重建前交叉韧带损伤后韧带断裂或松弛后不稳定的关节。(C)2007骨科研究学会。由威利期刊公司出版
The anatomical structure at bone-tendon and bone-ligament interfaces is called the enthesis. Histologically, the enthesis is characterized by a transitional series of tissue layers from the end of the tendon to bone, including tendon, fibrocartilage, calcified fibrocartilage, and bone. This arrangement yields stronger direct connection of the soft tissues to bone. In surgical repair, the enthesis has proven difficult to reproduce, and the success of ligament-bone bonding has depended on the fibrous attachment that forms after any ligament reconstructions. In this study, we attempted to generate a direct-insertion enthesis in two stages. First, recombinant human bone morphogenetic protein-2 (rhBMP-2) was injected into the flexor digitorum communis tendon in the rabbit hind limb to induce ectopic ossicle formation. In a second step, the resultant tendon/ossicle complex was then surgically transferred onto the surface of the rabbit tibia to generate a stable tendon-bone junction. One month following surgery, histomorphological examination confirmed direct insertion of tendon-bone structures in the proximal tibia of the rabbit. Ultimate failure loads of the BMP-2-generated tendon-bone junction were significantly higher than in the control group (p < 0.01). These findings suggest that it is possible to successfully regenerate a direct tendon-to-bone enthesis. Use of this approach may enable successful reconstruction of joints rendered unstable after ligamentous rupture or laxity after anterior cruciate ligament injury. (C) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.