2021
DOI: 10.3389/fbioe.2021.756930
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Tackling the Challenges of Graft Healing After Anterior Cruciate Ligament Reconstruction—Thinking From the Endpoint

Abstract: Anterior cruciate ligament (ACL) tear is common in sports and accidents, and accounts for over 50% of all knee injuries. ACL reconstruction (ACLR) is commonly indicated to restore the knee stability, prevent anterior–posterior translation, and reduce the risk of developing post-traumatic osteoarthritis. However, the outcome of biological graft healing is not satisfactory with graft failure after ACLR. Tendon graft-to-bone tunnel healing and graft mid-substance remodeling are two key challenges of biological gr… Show more

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Cited by 23 publications
(23 citation statements)
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“…The clinical outcomes of ACLR continue to require significant improvement, especially for young adults and athletes who desire to return to pre-injury sporting activity [ 3 ]. The rate of the return to pre-injury activity level ranges from 37% to 75% [ 5 ]. In addition, graft healing after ACLR is very slow, leading to a long period of recovery time even with carefully monitored rehabilitation [ 5 ].…”
Section: Discussionmentioning
confidence: 99%
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“…The clinical outcomes of ACLR continue to require significant improvement, especially for young adults and athletes who desire to return to pre-injury sporting activity [ 3 ]. The rate of the return to pre-injury activity level ranges from 37% to 75% [ 5 ]. In addition, graft healing after ACLR is very slow, leading to a long period of recovery time even with carefully monitored rehabilitation [ 5 ].…”
Section: Discussionmentioning
confidence: 99%
“…ACL reconstruction (ACLR) remains the gold standard of treatment for ACL ruptures in young adults and athletes [ 3 ]. Although ACLR has a satisfactory success rate (73–95%), a significant number of patients cannot return to their pre-injury level of sport [ 4 , 5 ]. Additionally, because of the low healing capacity of ACL, it has been advocated that a post-surgery period of up to 12 m should be allowed in facilitating the biological recovery of the joint [ 6 ].…”
Section: Introductionmentioning
confidence: 99%
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“…Tendon graft-to-bone tunnel integration after ACLR involves slow biological processes consisting of three key healing processes and requires more than 12 months for graft maturation [ [13] , [14] , [15] , [16] , [17] ]. Therefore, there has been substantial interest in exploring biological strategies, including drugs, growth factors, platelet-rich plasma (PRP), stem cells, stem cell-conditioned media, biomaterials, and biophysical interventions, to facilitate tendon graft-to-bone tunnel integration and promote earlier graft maturation, which may allow earlier recovery and earlier return to play [ [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] ].…”
Section: Introductionmentioning
confidence: 99%