The Effect of Transforming Growth Factor-β1 on Intraosseous Healing of Flexor Tendon Autograft Replacement of Anterior Cruciate Ligament in Dogs

Yamazaki, Shuji; Yasuda, Kazunori; Tomita, Fumihisa; Tohyama, Harukazu; Minami, Akio

doi:10.1016/j.arthro.2005.05.011

Cited by 128 publications

(82 citation statements)

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“…Exogenous osteoinductive agents had been used in an attempt to augment this healing. 15,16 However, researchers just focused on the agents themselves, and there have been no studies to compare the effect of different carriers with the agents on the osteointegration of grafted tendon in bone tunnels. This study used two kinds of carriers of different biodegradation rates with BMP to increase this process.…”

Section: Discussionmentioning

confidence: 99%

“…This fixation method could result in substantial differences in the mechanical environment, which in turn are likely to affect the healing process, but this reconstruction method is a very common model used in animal studies for ACL reconstruction. 15,16 We have to recognize that these factors may have affected the results in this study. Second, crude BMPs were used instead of rhBMP-2 or other kinds of BMP, as some studies have reported that the way forward in the therapeutic application of BMP is to use them in combination.…”

Section: Comparative In Vivo Study Of Injectable Biomaterialsmentioning

confidence: 99%

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Comparative in vivo study of injectable biomaterials combined with BMP for enhancing tendon graft osteointegration for anterior cruciate ligament reconstruction

Pan

Wei

Zhou

et al. 2011

Journal Orthopaedic Research

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This study was to compare effect of osteointegration of grafted tendon in bone tunnels between injected calcium phosphate cement (ICPC) and injected fibrin sealant (IFS) combined with bone morphogenetic protein (BMP) after anterior cruciate ligament (ACL) reconstruction. ACL reconstruction was performed bilaterally in 51 rabbits. ICPC-BMP composite was injected into one knee, with the contralateral knee IFS-BMP composite. The rabbits were killed at postoperative weeks 2, 6, and 12 for testing. Histological observations showed the ICPC composite gradually increased the new bone formation during the whole healing process, while the IFS composite had a burst effect on enhancing the healing of tendon-to-bone at 2 and 6 weeks. By 12 weeks, there was more new cartilage and new bone in the interface in the ICPC-bBMP group. Micro-CT showed that the values of BMD in the ICPC-bBMP group were lower than those in the IFSbBMP group at 6 weeks, while the values in the ICPC-bBMP group were higher than those in the IFS-bBMP group at 12 weeks (p > 0.05). Fluorescent labels showed that the rate of new bone formation of IFS-BMP composite was significantly higher than that of ICPC composite at 6 weeks (3.45 AE 0.62 mm/day vs. 2.93 AE 0.51 mm/day), but the rate was decreased compared with ICPC composite at 12 weeks (2.58 AE 0.72 mm/day vs. 3.05 AE 0.68 mm/day; p < 0.05). Biomechanically, the ultimate failure load in the ICPC-BMP group was always higher than that in the IFS-BMP group. It is evident that the ICPC composite achieved a more prolonged osteogenic effect than that by IFS composite. ß

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Section: Discussionmentioning

confidence: 99%

Section: Comparative In Vivo Study Of Injectable Biomaterialsmentioning

confidence: 99%

Comparative in vivo study of injectable biomaterials combined with BMP for enhancing tendon graft osteointegration for anterior cruciate ligament reconstruction

Pan

Wei

Zhou

et al. 2011

Journal Orthopaedic Research

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“…Histological examination showed that the CPC produced early, diffuse and massive bone ingrowth, leading to increased pullout strength. In another study (Yamazaki et al 2005), the ACL was reconstructed in a dog model with a flexor tendon treated with 2 ng of TGF-β1 mixed with 0.1 mL of fibrin sealant. The pullout strength was increased, and the histology showed that there was rich generation of perpendicular fibers connecting the tendon to bone.…”

Section: Discussionmentioning

confidence: 99%

Improved healing of ligament to bone with point fixation in rabbits

et al. 2006

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Background Secure healing of soft tissue to bone is a prerequisite for many orthopedic operations. This healing can be achieved either by pressing the tissue against the bone (press fixation) or by suturing the soft tissue to the bone (point fixation).Experiments and findings We tested the hypothesis that point fixation of soft tissue to bone results in better mechanical properties than press fixation. 10 skeletally mature New Zealand White rabbits were operated on bilaterally at the knees. The medial collateral ligaments were fixated to the bone just above the original insertion on the tibia. Two types of plates were used for this purpose, one with flat undersurface (left knee) and the other one with a pegged undersurface (right knee). The pegged plate was thought to mimic fixation achieved with suture anchors. After 4 weeks, mechanical testing revealed an almost doubled force at failure, stiffness and energy uptake in the knees operated with the pegged plates.Interpretation Suture anchors or devices with a pegged undersurface are better for soft tissue fixation to bone than devices with a flat surface, such as screws with washers or staples.

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“…Experimental data have shown that some methods, such as mechanical stimulation [25], tendon wrapping with periosteum [6] and interface filling with growth factors [1,27], bone marrow stromal cells [14] or biomaterials [17,22], can enhance the underlying biological processes of tendon-bone tunnel osteointegration. Biomaterials have been developed to further promote the tendon-bone healing of grafted tendons.…”

Section: Introductionmentioning

confidence: 99%

Recombined bone xenografts enhance tendon graft osteointegration of anterior cruciate ligament reconstruction

Pan

Wei

et al. 2009

International Orthopaedics (SICOT)

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The objective of the study was to discover whether recombined bone xenograft (RBX), a porous solid material, could augment healing of the tendon-to-bone interface after anterior cruciate ligament (ACL) reconstruction. ACL reconstruction was performed bilaterally in 25 skeletally mature rabbits using long digital extensor tendon grafts. RBX was implanted into the treated knee, with the contralateral knee serving as control. Three rabbits were killed at postoperative weeks two, six and 12 for routine histology. The remaining 16 rabbits were killed at weeks six and 12, and their femur-graft-tibia complexes were harvested for mechanical testing. The treatment and control groups produced different histological findings at the interface between the tendon and bone. In the treatment group, large areas of chondrocyte-like cells were noted around the tendon-bone interface two weeks after the operation. At six weeks, more abundant bone formation was observed around the tendon. At 12 weeks, an immature neoenthesis structure was seen. In biomechanical evaluation six and 12 weeks after the operation, the ultimate strength of tendon in the bone tunnel was significantly higher in the treatment group than in the control group. RBX can augment the osteointegration of tendon to bone after ACL reconstruction.Résumé L'objectif de cette étude est d'évaluer l'intérêt d'un matériel solide et poreux du type xénogreffe osseuse recombinée. Cette greffe osseuse recombinée (RBX), peutelle augmenter les chances de consolidation au niveau de l'interface tendon-os après reconstruction du ligament croisé antérieur (ACL). Matériel et méthode: une reconstruction du ligament croisé antérieur a été réalisée de façon bilatérale sur 25 lapins « squelettiques » en utilisant une greffe du tendon du long extenseur. RBX a été implanté dans les genoux traités, le genou contro latéral servant de contrôle. Trois lapins ont été sacrifiés à 2,6 et 12 semaines avec un examen histologique de routine, les 16 lapins restant ont été sacrifiés à 6 et 12 semaines, le complexe osseux fémoro tibial ayant été testé mécaniquement. Résultat, le groupe contrôle non traité montre une différ-ence histologique au niveau de l'interface entre le tendon et l'os. Dans le groupe traité par RBX, de larges plages cellulaires de chondrocytes-like ont été repérés autour de l'interface tendon-os 2 semaines après l'opération. 12 semaines après, des formations plus importantes ont été observées autour du tendon de même qu'une néofixation de type immature. L'évaluation bio mécanique a montré que 12 semaines après l'opération l'insertion tendineuse au niveau du tunnel osseux est beaucoup plus solide dans le groupe des lapins traités que dans le groupe contrôle. En conclusion le RBX peut augmenter l'ostéo intégration osseuse de la jonction tendineuse dans les réparations du ligament croisé antérieur. Abbreviations ACLAnterior cruciate ligament RBX Recombined bone xenograft QSTG Quadrupled semitendinosus and gracilis tendons BPTB Bone-patella tendon-bone SEM Scanning electron micr...

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The Effect of Transforming Growth Factor-β1 on Intraosseous Healing of Flexor Tendon Autograft Replacement of Anterior Cruciate Ligament in Dogs

Cited by 128 publications

References 29 publications

Comparative in vivo study of injectable biomaterials combined with BMP for enhancing tendon graft osteointegration for anterior cruciate ligament reconstruction

Comparative in vivo study of injectable biomaterials combined with BMP for enhancing tendon graft osteointegration for anterior cruciate ligament reconstruction

Improved healing of ligament to bone with point fixation in rabbits

Recombined bone xenografts enhance tendon graft osteointegration of anterior cruciate ligament reconstruction

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