A new strategy to enhance artificial ligament graft osseointegration in the bone tunnel using hydroxypropylcellulose.

PURPOSE: The aim of this study was to determine whether hydroxypropylcellulose (HPC) coating of polyethylene terephthalate (PET) artificial ligaments enhances graft osseointegration in the bone tunnel. METHODS: Thirty New Zealand white rabbits underwent artificial ligament graft transplantation in the bilateral proximal tibia tunnels. One limb was implanted with an HPC-coated PET graft, and the contralateral limb was implanted with a non-HPC-coated PET graft as a control. The rabbits were then randomly sacrificed at weeks four and eight after surgery for biomechanical testing, histological examination, and histomorphometric and real-time polymerase chain reaction analysis. RESULTS: At week four after surgery, there were no statistically significant differences in the load to failure or stiffness values between the experimental and control limbs (P = 0.328 and P = 0.128, respectively). At week eight after surgery, the mean load to failure and stiffness value of the experimental limbs was higher than that of the control limbs (P < 0.001 and P = 0.018, respectively). At week eight after surgery, some protruding new bone tissue from the host bone to the graft was found in the HPC-coated group, while a thick fibrous tissue band was observed at the interface between the graft and the host bone in the control group. Histomorphometric analysis showed that the graft-bone interface width in the HPC-coated group was significantly narrower than that in the control group at week eight after surgery (P < 0.001). At weeks four and eight after surgery, the mRNA expression level of bone morphogenetic protein-2 in the HPC group was higher than that in the control group (P = 0.001 and P = 0.010, respectively). The mRNA expression level of osteopontin in the HPC group was higher than that in the control group only at week four after surgery (P = 0.032). CONCLUSIONS: Our data show that an HPC coating on the surface of PET artificial ligament grafts may induce artificial ligament graft osseointegration in the bone tunnel.