Effect of Immediate and Delayed High-Strain Loading on Tendon-to-Bone Healing After Anterior Cruciate Ligament Reconstruction

Packer, Jonathan D.; Bedi, Asheesh; Fox, Allison M.; Gasinu, Selom; Imhauser, Carl W.; Stasiak, Mark; Deng, Xiang; Rodeo, Scott A.

doi:10.2106/jbjs.l.01354

Cited by 40 publications

(38 citation statements)

References 33 publications

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“…Our laboratory has been investigating the effect of mechanical load on healing of a tendon graft in a bone tunnel. [4][5][6] The mechanical environment at the healing tendon-bone interface is affected by several different variables, including the amount of initial graft tension, the position of the bone tunnels, physical properties of the graft, and positioning of the knee at time of fixation. [7][8][9][10] The optimal level of initial graft tension and its effect on the biologic events of healing is unknown.…”

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confidence: 99%

Indian hedgehog signaling and the role of graft tension in tendon‐to‐bone healing: Evaluation in a rat ACL reconstruction model

Carbone

Carballo

et al. 2015

Journal Orthopaedic Research

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ABSTRACT:The structure and composition of the native enthesis is not recapitulated following tendon-to-bone repair. Indian Hedgehog (IHH) signaling has recently been shown to be important in enthesis development in a mouse model but no studies have evaluated IHH signaling in a healing model. Fourteen adult male rats underwent ACL reconstruction using a flexor tendon graft. Rats were assigned to two groups based on whether or not they received 0N or 10N of pre-tension of the graft. Specimens were evaluated at 3 and 6 weeks post-operatively using immunohistochemistry for three different protein markers of IHH signaling. Quantitative analysis of staining area and intensity using custom software demonstrated that IHH signaling was active in interface tissue formed at the healing tendon-bone interface. We also found increased staining area and intensity of IHH signaling proteins at 3 weeks in animals that received a pre-tensioned tendon graft. No significant differences were seen between the 3-week and 6-week time points. Our data suggests that the IHH signaling pathway is active during the tendon-bone healing process and appears to be mechanosensitive, as pretensioning of the graft at the time of surgery resulted in increased IHH signaling at three weeks. ß

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confidence: 99%

Indian hedgehog signaling and the role of graft tension in tendon‐to‐bone healing: Evaluation in a rat ACL reconstruction model

Carbone

Carballo

et al. 2015

Journal Orthopaedic Research

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“…Specific to rat models of ACL reconstruction, we reported a peak load of 13.3 N and stiffness of 16.0 N/mm for collagen coated PCL grafts 12 weeks after implantation in Sprague–Dawley rats . Packer et al reported a peak load of approximately 7 N and a stiffness of approximately 3.5 N/mm 2 weeks after undergoing ACL reconstruction with FDL autograft . Fu et al found that Sprague–Dawley rats reconstructed with FDL autograft had approximately 25–30% the stiffness and peak load of native ACL after 6 weeks .…”

Section: Discussionmentioning

confidence: 69%

Use of ultra-high molecular weight polycaprolactone scaffolds for ACL reconstruction

et al. 2015

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Previously, we reported on the implantation of electrospun polycaprolactone (PCL) grafts for use in ACL tissue engineering in a small animal model. In the present study, we hypothesized that grafts fabricated from ultra-high molecular weight polycaprolactone (UHMWPCL) would have similarly favorable biologic properties but superior mechanical properties as compared to grafts fabricated from PCL. Two forms of polycaprolactone were obtained (UHMWPCL, MW ¼ 500 kD, and PCL, MW ¼ 80 kD) and electrospun into scaffolds that were used to perform ACL reconstruction in 7-8 week old male Lewis rats. The following groups were examined: UHMWPCL, PCL, flexor digitorum longus (FDL) allograft, native ACL, as well as sham surgery in which the ACL was transsected. At 16 weeks post-operatively, biomechanical testing, histology, and immunohistochemistry (IHC) were performed. Analysis of cellularity indicated that there was no significant difference among the UHMWPCL, PCL, and FDL allograft groups. Quantification of birefringence from picrosirius red staining demonstrated significantly more aligned collagen fibers in the allograft than the PCL group, but no difference between the UHMWPCL and allograft groups. The peak load to failure of the UHMWPCL grafts was significantly higher than PCL, and not significantly different from FDL allograft. This in vivo study establishes the superiority of the higher molecular weight version of polycaprolactone over PCL as a scaffold material for ACL reconstruction. By 16 weeks after implantation, the UHMWPCL grafts were not significantly different from the FDL allografts in terms of cellularity, peak load to failure, stiffness, and collagen fiber alignment. ß

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“…34,35 The bone mineral density (BMD), tissue mineral density (TMD), and bone volume fraction (bone volume/total volume, BV/TV) were calculated for a volume of interest at the greater tuberosity. At 2, 4 and 8 weeks aer surgery, 24 animals (8 animals per group per time period) were subjected to microcomputed tomography (microCT) analysis.…”

Section: In Vivo Tissue Regeneration Using Chronic Rct Modelmentioning

confidence: 99%

A hierarchical, stretchable and stiff fibrous biotemplate engineered using stagger-electrospinning for augmentation of rotator cuff tendon-healing

Zhao

Dong

et al. 2015

J. Mater. Chem. B

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Effect of Immediate and Delayed High-Strain Loading on Tendon-to-Bone Healing After Anterior Cruciate Ligament Reconstruction

Cited by 40 publications

References 33 publications

Indian hedgehog signaling and the role of graft tension in tendon‐to‐bone healing: Evaluation in a rat ACL reconstruction model

Indian hedgehog signaling and the role of graft tension in tendon‐to‐bone healing: Evaluation in a rat ACL reconstruction model

Use of ultra-high molecular weight polycaprolactone scaffolds for ACL reconstruction

A hierarchical, stretchable and stiff fibrous biotemplate engineered using stagger-electrospinning for augmentation of rotator cuff tendon-healing

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