Ligament-Tendon Fixation: Analysis of a New Stitch and Comparison With Standard Techniques

Krackow, Kenneth A.; Thomas, Stephen C.; Jones, Lynne C.

doi:10.3928/0147-7447-19880601-11

Cited by 160 publications

(85 citation statements)

References 11 publications

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“…The frayed and degenerated tissue is resected back to healthy tendon, the quadriceps muscle and tendon is mobilized, and number-5 nonabsorbable suture is passed in a Krackow pattern through the quadriceps tendon and is tied through drill-holes in the patella 19 (Figs. 2-A through 2-E).…”

Section: Fig 2-bmentioning

confidence: 99%

Quadriceps Tendon Rupture After Total Knee Arthroplasty

Dobbs

Hanssen

Lewallen

et al. 2005

The Journal of Bone & Joint Surgery

101

113

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Section: Fig 2-bmentioning

confidence: 99%

Quadriceps Tendon Rupture After Total Knee Arthroplasty

Dobbs

Hanssen

Lewallen

et al. 2005

The Journal of Bone & Joint Surgery

101

113

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show abstract

“…Current strategies to treat damaged tendons such as suturing, autografts or allografts are often associated with limitations like injury relapse [3], donor site morbidity [4] and risk of disease transmission, respectively. A potential solution suggested is the in vitro differentiation of mesenchymal stem cells (MSCs) on a mechanically competent biomaterial followed by transplantation to facilitate tendon repair [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Tenogenic differentiation of human MSCs induced by the topography of electrochemically aligned collagen threads

et al. 2012

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Topographical cues from the extracellular microenvironment can influence cellular activity including proliferation and differentiation. Information on the effects of material topography on tenogenic differentiation of human mesenchymal stem cells (human MSCs) is limited. A methodology using the principles of isoelectric focusing has previously been developed in our laboratory to synthesize electrochemically aligned collagen (ELAC) threads that mimics the packing density, alignment and strength of collagen dense connective tissues. In the current study, human MSCs were cultured on ELAC and randomly-oriented collagen threads and the effect of collagen orientation on cell morphology, proliferation and tenogenic differentiation was investigated. The results indicate that higher rates of proliferation were observed on randomly oriented collagen threads compared to ELAC threads. On the other hand, tendon specific markers such as scleraxis, tenomodulin, tenascin-C and collagen-III were significantly increased on ELAC threads compared to randomly oriented collagen threads. Additionally, osteocalcin, a specific marker of bone differentiation was suppressed on ELAC threads. Previous studies have reported that BMP-12 is a key growth factor to induce tenogenic differentiation of human MSCs. To evaluate the synergistic effect of BMP-12 and collagen orientation, human MSCs were cultured on ELAC threads in culture medium supplemented with and without BMP-12. The results revealed that BMP-12 did not have an additional effect on the tenogenic differentiation of human MSCs on ELAC threads. Together, these results suggest that ELAC induces tenogenic differentiation of human MSCs by presenting an aligned and dense collagen substrate, akin to the tendon itself. In conclusion, ELAC has a significant potential to be used as a tendon replacement and in the development of an osteotendinous construct towards the regeneration of bone-tendon interfaces.

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“…In this study, a combination of both Krackow [35, 36] and running whipstitch techniques were used in each animal. One of the known drawbacks of the whipstitch techniques is tendon elongation and gap formation at the repair site [37].…”

Section: Discussionmentioning

confidence: 99%

Augmentation and repair of tendons using demineralised cortical bone

Elnikety

Pendegrass

Godoy

et al. 2016

BMC Musculoskelet Disord

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BackgroundIn severe injuries with loss of tendon substance a tendon graft or a synthetic substitute is usually used to restore functional length. This is usually associated with donor site morbidity, host tissue reactions and lack of remodelling of the synthetic substitutes, which may result in suboptimal outcome. A biocompatible graft with mechanical and structural properties that replicate those of normal tendon and ligament has so far not been identified. The use of demineralised bone for tendon reattachment onto bone has been shown to be effective in promoting the regeneration of a normal enthesis. Because of its properties, we proposed that Demineralised Cortical Bone (DCB) could be used in repair of a large tendon defect.MethodsAllogenic DCB grafts in strip form were prepared from sheep cortical bone by acid decalcification and used to replace the enthesis and distal 1 cm of the ovine patellar tendon adjacent to the tibial tuberosity. In 6 animals the DCB strip was used to bridge the gap between the resected end of the tendon and was attached with bone anchors. Force plate analysis was done for each animal preoperatively and at weeks 3, 9, and 12 post operatively. At week 12, after euthanasia x-rays were taken and range of movements were recorded for hind limbs of each animal. Patella, patellar tendon – DCB and proximal tibia were harvested as a block and pQCT scan was done prior to histological analysis.ResultsOver time functional weight bearing significantly increased from 44% at 3 weeks post surgery to 79% at week 12. On retrieval none of the specimens showed any evidence of ossification of the DCB. Histological analysis proved formation of neo-enthesis with presence of fibrocartilage and mineralised fibrocartilage in all the specimens. DCB grafts contained host cells and showed evidence of vascularisation. Remodelling of the collagen leading to ligamentisation of the DCB was proved by the presence of crimp in the DCB graft on polarized microscopy.ConclusionCombined with the appropriate surgical techniques, DCB can be used to achieve early mobilization and regeneration of a tendon defect which may be applicable to the repair of chronic rotator cuff injury in humans.

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Ligament-Tendon Fixation: Analysis of a New Stitch and Comparison With Standard Techniques

Cited by 160 publications

References 11 publications

Quadriceps Tendon Rupture After Total Knee Arthroplasty

Quadriceps Tendon Rupture After Total Knee Arthroplasty

Tenogenic differentiation of human MSCs induced by the topography of electrochemically aligned collagen threads

Augmentation and repair of tendons using demineralised cortical bone

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