Incorporating BMP-2 and skeletal muscle to a semitendinosus autograft in an oversized tunnel yields robust bone tunnel ossification in rabbits: Toward single-step revision of failed anterior cruciate ligament reconstruction.
Knee
; 25(5): 765-773, 2018 Oct.
Article
in En
| MEDLINE
| ID: mdl-30057249
ABSTRACT
BACKGROUND:
Bone tunnel widening after anterior cruciate ligament (ACL) reconstruction is a known complication that can lead to graft failure. Subsequent revision surgery typically involves a two-stage procedure. The aim of this study was to test a novel autologous tendon graft retaining muscle tissue combined with Human Recombinant Bone Morphogenetic Protein-2 (rh-BMP-2) leading to rapid ossification of the muscle tissue, simultaneously replenishing bone stock and producing a mechanically stable bone-tendon insertion.METHODS:
In 12 skeletally mature New Zealand rabbits, the ACL was resected and oversized bone tunnels were drilled to model tunnel widening. The ipsilateral semitendinosus muscle-tendon graft was harvested and folded twice. Muscle tissue was removed in the middle third but retained at both distal ends. One side was wrapped in a collagen sponge loaded with rh-BMP-2 while the other end was used as its own control.RESULTS:
All animals were euthanized after six weeks. Micro-computed tomography (micro-CT) was used to analyze bone formation in 12 animals, with additional biomechanical testing to failure and histology performed for six animals each. Micro-CT showed that bone densities were higher by a factor of 2.4 in treated graft ends compared with their controls. Biomechanical testing showed a mean overall failure load of 37.5â¯N. Histology showed that the trabecular bone surrounding the implant was significantly (Pâ¯=â¯0.0087) thicker on the treated (85.5⯵m) compared with the control side (68.2⯵m).CONCLUSIONS:
We conclude that a semitendinosus graft retaining the muscle tissue stimulated by recombinant Bone Morphogenetic Protein-2 (BMP-2) allows robust osseointegration of the graft within an oversized bone tunnel in an animal model.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tendons
/
Osseointegration
/
Transforming Growth Factor beta
/
Bone Morphogenetic Protein 2
/
Anterior Cruciate Ligament Reconstruction
/
Hamstring Muscles
/
Anterior Cruciate Ligament Injuries
Type of study:
Prognostic_studies
Limits:
Animals
Language:
En
Journal:
Knee
Journal subject:
ORTOPEDIA
Year:
2018
Document type:
Article