Acceleration of Tendon-Bone Healing of Anterior Cruciate Ligament Graft Using Autologous Ruptured Tissue

作者：Matsumoto Tomoyuki^*; Kubo Seiji; Sasaki Ken; Kawakami Yohei; Oka Shinya; Sasaki Hiroshi; Takayama Koji; Tei Katsumasa; Matsushita Takehiko; Mifune Yutaka; Kurosaka Masahiro; Kuroda Ryosuke

来源：The American Journal of Sports Medicine, 2012, 40(6): 1296-1302.

DOI：10.1177/0363546512439026

• ACL reconstruction
• bone-tendon healing
• ruptured tissue
• stem cells

Background: It has been recently reported that human anterior cruciate ligament (ACL) ruptured tissue contains abundant vascular stem cells that contribute to tendon-bone healing in an immunodeficient rat model of ACL reconstruction. %26lt;br%26gt;Hypothesis: Autologous ruptured ACL tissue has an effect on the maturation of bone-tendon integration in anterior cruciate ligament reconstruction. %26lt;br%26gt;Study Design: Controlled laboratory study. %26lt;br%26gt;Methods: Twenty healthy adult beagle dogs underwent bilateral ACL reconstruction using the ipsilateral flexor digitorum superficialis tendon and were divided into 2 groups: right knee (a tissue-treated group) and left knee (a control group). The tissue-treated group received autologous ruptured ACL tissue, which was obtained 2 days after resection and sutured to the tibial side of the graft. Histological, radiographic, and biomechanical assessments were performed. In addition, immunohistochemical staining was performed to assess angiogenesis and osteogenesis. %26lt;br%26gt;Results: Histological assessment and staining for osteoblasts and endothelial cells at week 2 demonstrated early healing, inducing endochondral ossification-like integration with enhanced angiogenesis and osteogenesis in the tissue-treated group%26apos;s grafts. Computed tomography at week 4 showed a significantly smaller tibial bone tunnel in the tissue-treated group (tissue, 19.0 +/- 4.4 mm(2); control, 42.6 +/- 4.7 mm(2); P = .009, n = 5). Furthermore, biomechanical testing of force during loading to ultimate failure at week 4 demonstrated a significantly higher strength in the tissue-treated group (tissue, 66.4 +/- 10.1 N; control, 30.5 +/- 10.3 N; P = .009, n = 5). %26lt;br%26gt;Conclusion: In the present study, the authors elucidated that transplantation of ACL-ruptured tissue, which was sutured to the tibial side of the graft, contributed to early tendon-bone healing in a canine model of ACL reconstruction. %26lt;br%26gt;Clinical Relevance: Anterior cruciate ligament ruptured tissue has a therapeutic potential in promoting an appropriate environment for tendon-to-bone healing in bone tunnels of ACL reconstruction.

• 出版日期2012-6