Biological considerations of tendon graft incorporation within the bone tunnel
Section snippets
Histology of graft incorporation
It is well accepted that the bone plug of bone–patella tendon–bone graft becomes anchored to the bone wall by appositional bone formation and that the grafted bone becomes necrotic as new bone forms.5, 8 Several recent studies have demonstrated the time course of this bone-to-bone healing. Tomita and coworkers evaluated the histologic response using adult beagle dogs at 3, 6, and 12 weeks.11 At 3 weeks, one side of the graft was in contact with the bony wall, whereas the opposite side gap
Augmentation techniques
Improvements in soft tissue graft healing to bone are critical to allow more aggressive and earlier rehabilitation and an earlier return to sports and activities. Thus, biological solutions to stimulate the graft incorporation within the bone tunnel appear to be a promising approach. Several recent studies in animals of various augmentation techniques show promise.
Ligament tissue engineering
The technical aspects of autograft and allograft ACL replacements have undergone improvements over the last 10 years and yield an overall success rate of about 90%.31, 32, 33, 34 Despite the ability to adapt to the mechanical demands both autografts and allografts do not reach the structural identity of either the original tendon tissue or the native ACL. In addition, autografts are associated with donor site morbidity in up to 40% of all patients.35, 36, 37 On the other hand, allograft
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Anterior cruciate ligament prostheses using biotextiles
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2014, Journal of Bone and Joint SurgeryCitation Excerpt :These promising animal results demonstrate the feasibility of the use of biomimetic patches and scaffolds in interface tissue engineering. The success of these approaches will require a thorough understanding of the structure-function relationship at the native insertion site, as well as the elucidation of the mechanisms governing interface regeneration63,65. Low-intensity pulsed ultrasound (LIPUS) is defined as a frequency of 1.5 MHz administered in bursts of 200 ms, which delivers 30 mW/cm2 of energy66.
Small laboratory animal models of anterior cruciate ligament reconstruction
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