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Article: Peri-graft bone mass and connectivity as predictors for the strength of tendon-to-bone attachment after anterior cruciate ligament reconstruction

TitlePeri-graft bone mass and connectivity as predictors for the strength of tendon-to-bone attachment after anterior cruciate ligament reconstruction
Authors
Issue Date2009
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/bone
Citation
Bone, 2009, v. 45 n. 3, p. 545-552 How to Cite?
AbstractThe present study was designed to compare peri-graft bone mass and microarchitecture with tendon-to-bone (T-B) attachment strength after anterior cruciate ligament (ACL) reconstruction in a rabbit model. Surgical reconstruction using digital extensor tendon in bone tunnel was performed on 58 rabbits. Forty-two of the 58 rabbits were sacrificed at week 0, 2, 6 and 12 after operation respectively. The femur-graft-tibia complexes were harvested for pQCT and micro-CT examination to characterize the spatiotemporal changes of peri-graft bone in T-B healing in conjunction with histological examination. The remaining 16 rabbits were euthanized at week 6 and 12 postoperatively (i.e. 8 rabbits for each time point) for pull-out test after micro-CT examination to investigate the relationship between the T-B attachment strength and peri-graft bone mass/microarchitecture. Peri-graft BMD, BV/TV and connectivity was significantly lower at week 6 than those at time zero although there were no significant changes detected in the first 2 postoperative weeks. In addition, peri-graft bone mass and connectivity was significantly lower on the tibial side than those on the femoral side; and osteoclasts accumulated on the surface of peri-graft bone. Grafted tendon was prone to be pulled out from the tibial tunnel with bone attachment; the weakest point of the complexes shifted from the healing interface at time zero to peri-graft bone at week 6 after operation. With reverse of peri-graft bone at week 12 postoperatively, the weakest point shifted to the intra-osseous tendinous portion. The stiffness of T-B attachment correlated with peri-graft BV/TV (r2 = 0.68, p = 0.001) and connectivity (r2 = 0.47, p = 0.013) at week 6 after operation. T-B healing was a highly dynamic process of emergence and maintenance of peri-graft bone. T-B attachment strength was in relation to peri-graft bone mass and connectivity after ACL reconstruction. The measurement of peri-graft bone should be useful to monitor the quality of T-B healing and guide the postoperative rehabilitation.
Persistent Identifierhttp://hdl.handle.net/10722/131078
ISSN
2015 Impact Factor: 3.736
2015 SCImago Journal Rankings: 1.752
ISI Accession Number ID
Funding AgencyGrant Number
Research Grant CouncilCUHK4497/06M
Funding Information:

This study is supported by the Research Grant Council Earmarked Grants 06-07 (CUHK4497/06M), Hong Kong SAR, China. The authors Would like to thank Margaret Wan-Nar Wong, Po-Yee Lui and Saichuen Fu who provided expertises at academic meetings as well as Hui-Yan Yeung, Chun-Wai Chan, Grace Ho and Anita Wai-Ting Shum who gave technical assistance.

 

DC FieldValueLanguage
dc.contributor.authorWen, CY-
dc.contributor.authorQin, L-
dc.contributor.authorLee, KM-
dc.contributor.authorChan, KM-
dc.date.accessioned2011-01-18T07:00:34Z-
dc.date.available2011-01-18T07:00:34Z-
dc.date.issued2009-
dc.identifier.citationBone, 2009, v. 45 n. 3, p. 545-552-
dc.identifier.issn8756-3282-
dc.identifier.urihttp://hdl.handle.net/10722/131078-
dc.description.abstractThe present study was designed to compare peri-graft bone mass and microarchitecture with tendon-to-bone (T-B) attachment strength after anterior cruciate ligament (ACL) reconstruction in a rabbit model. Surgical reconstruction using digital extensor tendon in bone tunnel was performed on 58 rabbits. Forty-two of the 58 rabbits were sacrificed at week 0, 2, 6 and 12 after operation respectively. The femur-graft-tibia complexes were harvested for pQCT and micro-CT examination to characterize the spatiotemporal changes of peri-graft bone in T-B healing in conjunction with histological examination. The remaining 16 rabbits were euthanized at week 6 and 12 postoperatively (i.e. 8 rabbits for each time point) for pull-out test after micro-CT examination to investigate the relationship between the T-B attachment strength and peri-graft bone mass/microarchitecture. Peri-graft BMD, BV/TV and connectivity was significantly lower at week 6 than those at time zero although there were no significant changes detected in the first 2 postoperative weeks. In addition, peri-graft bone mass and connectivity was significantly lower on the tibial side than those on the femoral side; and osteoclasts accumulated on the surface of peri-graft bone. Grafted tendon was prone to be pulled out from the tibial tunnel with bone attachment; the weakest point of the complexes shifted from the healing interface at time zero to peri-graft bone at week 6 after operation. With reverse of peri-graft bone at week 12 postoperatively, the weakest point shifted to the intra-osseous tendinous portion. The stiffness of T-B attachment correlated with peri-graft BV/TV (r2 = 0.68, p = 0.001) and connectivity (r2 = 0.47, p = 0.013) at week 6 after operation. T-B healing was a highly dynamic process of emergence and maintenance of peri-graft bone. T-B attachment strength was in relation to peri-graft bone mass and connectivity after ACL reconstruction. The measurement of peri-graft bone should be useful to monitor the quality of T-B healing and guide the postoperative rehabilitation.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/bone-
dc.relation.ispartofBone-
dc.subject.meshAnimals-
dc.subject.meshAnterior Cruciate Ligament - surgery-
dc.subject.meshFemur - physiology-
dc.subject.meshTendons - physiology - transplantation-
dc.subject.meshTibia - physiology-
dc.titlePeri-graft bone mass and connectivity as predictors for the strength of tendon-to-bone attachment after anterior cruciate ligament reconstructionen_US
dc.typeArticleen_US
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=8756-3282&volume=45&issue=3&spage=545&epage=552&date=2009&atitle=Peri-graft+bone+mass+and+connectivity+as+predictors+for+the+strength+of+tendon-to-bone+attachment+after+anterior+cruciate+ligament+reconstruction-
dc.identifier.emailWen, CY: paulwen@hku.hk,wenchunyi@ort.cuhk.edu.hk-
dc.identifier.emailChan, KM: kaimingchan@cuhk.edu.hk-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.bone.2008.08.112-
dc.identifier.pmid18778801-
dc.identifier.scopuseid_2-s2.0-67949097323-
dc.identifier.hkuros174676-
dc.identifier.hkuros188833-
dc.identifier.volume45-
dc.identifier.issue3-
dc.identifier.spage545-
dc.identifier.epage552-
dc.identifier.isiWOS:000269378200021-
dc.identifier.citeulike5492922-

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