Effects of Demineralized Bone Matrix on Tendon-Bone Healing in an Intra-articular Rodent Model

Lovric, Vedran; Chen, Dong; Yu, Youcheng; Oliver, Rema A.; Genin, Francois; Walsh, William R.

doi:10.1177/0363546512457648

Cited by 36 publications

(36 citation statements)

References 36 publications

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“…Evidence from literature suggests that different BMPs found in demineralised bone result in differentiation of the MSCs into osteogenic, chondrogenic and tenogenic lineage [16, 17]. Rodeo and colleagues investigated the role of BMP-2 in tendon bone healing and concluded that BMP-2 enhances this healing and results in stronger tendon-bone attachment [18–20]. Similar findings were also found by other research groups [21–24].…”

Section: Introductionsupporting

confidence: 56%

Augmentation and repair of tendons using demineralised cortical bone

Elnikety

Pendegrass

Godoy

et al. 2016

BMC Musculoskelet Disord

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BackgroundIn severe injuries with loss of tendon substance a tendon graft or a synthetic substitute is usually used to restore functional length. This is usually associated with donor site morbidity, host tissue reactions and lack of remodelling of the synthetic substitutes, which may result in suboptimal outcome. A biocompatible graft with mechanical and structural properties that replicate those of normal tendon and ligament has so far not been identified. The use of demineralised bone for tendon reattachment onto bone has been shown to be effective in promoting the regeneration of a normal enthesis. Because of its properties, we proposed that Demineralised Cortical Bone (DCB) could be used in repair of a large tendon defect.MethodsAllogenic DCB grafts in strip form were prepared from sheep cortical bone by acid decalcification and used to replace the enthesis and distal 1 cm of the ovine patellar tendon adjacent to the tibial tuberosity. In 6 animals the DCB strip was used to bridge the gap between the resected end of the tendon and was attached with bone anchors. Force plate analysis was done for each animal preoperatively and at weeks 3, 9, and 12 post operatively. At week 12, after euthanasia x-rays were taken and range of movements were recorded for hind limbs of each animal. Patella, patellar tendon – DCB and proximal tibia were harvested as a block and pQCT scan was done prior to histological analysis.ResultsOver time functional weight bearing significantly increased from 44% at 3 weeks post surgery to 79% at week 12. On retrieval none of the specimens showed any evidence of ossification of the DCB. Histological analysis proved formation of neo-enthesis with presence of fibrocartilage and mineralised fibrocartilage in all the specimens. DCB grafts contained host cells and showed evidence of vascularisation. Remodelling of the collagen leading to ligamentisation of the DCB was proved by the presence of crimp in the DCB graft on polarized microscopy.ConclusionCombined with the appropriate surgical techniques, DCB can be used to achieve early mobilization and regeneration of a tendon defect which may be applicable to the repair of chronic rotator cuff injury in humans.

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Section: Introductionsupporting

confidence: 56%

Augmentation and repair of tendons using demineralised cortical bone

Elnikety

Pendegrass

Godoy

et al. 2016

BMC Musculoskelet Disord

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“…A unilateral rat ACL reconstruction model was adopted as described previously [41] and slightly modified [50]. The surgical procedure was performed under strictly aseptic conditions.…”

Section: Methodsmentioning

confidence: 99%

Intermittently Administered Parathyroid Hormone [1–34] Promotes Tendon-Bone Healing in a Rat Model

Shi

Jiang

et al. 2014

IJMS

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The objective of this study was to investigate whether intermittent administration of parathyroid hormone [1–34] (PTH[1–34]) promotes tendon-bone healing after anterior cruciate ligament (ACL) reconstruction in vivo. A rat model of ACL reconstruction with autograft was established at the left hind leg. Every day, injections of 60 μg PTH[1–34]/kg subcutaneously were given to the PTH group rats (n = 10) for four weeks, and the controls (n = 10) received saline. The tendon-bone healing process was evaluated by micro-CT, biomechanical test, histological and immunohistochemical analyses. The effects of PTH[1–34] on serum chemistry, bone microarchitecture and expression of the PTH receptor (PTH1R) and osteocalcin were determined. Administration of PTH[1–34] significantly increased serum levels of calcium, alkaline phosphatase (AP), osteocalcin and tartrate-resistant acid phosphatase (TRAP). The expression of PTH1R on both osteocytes and chondrocyte-like cells at the tendon-bone interface was increased in the PTH group. PTH[1–34] also enhanced the thickness and microarchitecture of trabecular bone according to the micro-CT analysis. The results imply that systematically intermittent administration of PTH[1–34] promotes tendon-bone healing at an early stage via up-regulated PTH1R. This method may enable a new strategy for the promotion of tendon-bone healing after ACL reconstruction.

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“…). In order to promote graft osseointegration, various methods had been engaged to reduce the fibrous scar tissue and enhance new bone formation at the graft‐bone interface …”

Section: Graft Healing Process After Implantationmentioning

confidence: 99%

“…In order to promote graft osseointegration, various methods had been engaged to reduce the fibrous scar tissue and enhance new bone formation at the graft-bone interface. 23,24 In addition, the graft ligamentization process of the intra-articular part consists of four phases: (1) inflammation, (2) revascularization, (3) cellular repopulation and resynovialization, and (4) remodeling. 25,26 The inserted graft is initially avascular without a synovial surface after ACL reconstruction.…”

Section: Graft Healing Process After Implantationmentioning

confidence: 99%

Biomedical coatings on polyethylene terephthalate artificial ligaments

Chen

2014

J Biomedical Materials Res

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This review comprehensively covers research conducted to enhance polyethylene terephthalate (PET) artificial ligament osseointegration in the bone tunnel. These strategies, using biocompatible or bioactive coatings, had a positive effect in promoting PET ligament osseointegration by increasing bone formation and decreasing fibrous scar tissue at the ligament-to-bone interface. The improved osseointegration can be translated into a significant increase in the biomechanical pull-out loads. However, the load-to-failure of coated ligament is far lower than that of native ACL. Coatings to promote intra-articular ligamentization are also discussed in this study. Collectively, our investigations may arouse further study of the biological coating of PET artificial ligaments in order to effectively enhance ligament osseointegration and promote artificial ligament ligamentization.

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Effects of Demineralized Bone Matrix on Tendon-Bone Healing in an Intra-articular Rodent Model

Abstract: Introduction of osteoinductive DBM at the tendon-bone interface during ACL reconstructive surgery may improve short-term outcomes.

Cited by 36 publications

References 36 publications

Augmentation and repair of tendons using demineralised cortical bone

Augmentation and repair of tendons using demineralised cortical bone

Intermittently Administered Parathyroid Hormone [1–34] Promotes Tendon-Bone Healing in a Rat Model

Biomedical coatings on polyethylene terephthalate artificial ligaments

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