The Actual Tendon-Bone Interface Strength in a Rabbit Model

Chronological changes in the collagen-type composition at tendon–bone interface in rabbits

“…Furthermore, the tendon midsubstance became mainly amorphous type III collagen during this period, so increasing deteriorations in quality were observed histologically. This finding strongly supports previous reports of mechanical experiments; Tsukada et al 18 found avulsion at the tendon side of the tendon–bone interface with Sharpey-like fibres left in the bone side until 8 weeks, and Tomita et al 13 found avulsion of the tendon graft with the outermost layer of the tendon left in the tunnel side at six weeks. Type III collagen Sharpey-like fibres, therefore, seem not to anchor as far as the deep part of the tendon graft.…”

“…6,13,17 However, some recent reports have pointed out that the tensile test cannot necessarily show that the strength of the tendon–bone interface increased sufficiently just because pullout failure instead of midsubstance failure occurred. 13,18,19 Specifically, a change in the failure mode observed when the Sharpey-like fibres appear simply indicates that the most mechanically weak point shifted from the tendon–bone interface to the midsubstance of the tendon graft. Therefore, whether the tendon–bone interface has actually gained sufficient strength is unclear.…”

“…Therefore, whether the tendon–bone interface has actually gained sufficient strength is unclear. Tsukada et al 18 evaluated the strength of the interface with their original model in which the tendon graft was reinforced with suture material to prevent tendon midsubstance rupture. In their report, all reinforced tendon grafts showed pullout failure until 12 weeks and midsubstance rupture after 16 weeks, while all tendon grafts with no reinforcement showed midsubstance rupture at eight weeks after surgery.…”

Biomechanical properties of repairs for dislocated AC joints using suture button systems with integrated tendon augmentation

“…Specific cortical button systems for such delayed repairs combine a biologic component (e.g., autologous semitendinosus tendon) and the technique of approaching the clavicle and coracoid via the primary fixation (e.g., a cortical button and suture pulley system) [4, 19]. Besides an improved primary stability, this is thought to result in a higher secondary stability when the tendon graft heals into the bone tunnels [21]. In contrast, non‐absorbable structures may create too much stiffness of the construct and result in fracture or graft failure.…”

Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits

“…[8][9][10][11][12][13][14] Still, in addition to the physiological difficulties, which may be experienced in the healing process, implementation materials may also affect the recovery phase negatively. Tsukada et al [28] histologically and biomechanically investigated the effect of the remaining sutures placed on the tendon in the tunnel by a study conducted on 60 rabbits. This study concluded that the sutures left in the tunnel had adverse effect on healing.…”