Enveloping the tendon graft with periosteum to enhance tendon-bone healing in a bone tunnel: A biomechanical and histologic study in rabbits

Chen, Chih-Hwa; Chen, Wen Jer; Shih, Chun–Hsiung; Yang, Chung Yeung; Liu, Shih‐Jung; Lin, Po‐Yen

doi:10.1053/jars.2003.50014

Cited by 94 publications

(98 citation statements)

References 11 publications

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“…They also underlined that tendon surgery should be protected for at least eight weeks until the tendon reaches sufficient strength at the 12 th week. In their study concerning protection of repair area, Chen et al [27] wrapped the tendon graft with the periosteum to evaluate tendon healing in the bone tunnel. In this study, it was shown that a fibrous tissue appeared first in tendons covered with periosteum, then a progressive fibrotic tissue grew advancing into the bone, thus organized collagen fibers extended between bone and tendon.…”

Section: Discussionmentioning

confidence: 99%

Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits

Taşkesen

Ataoğlu

Özer

et al. 2015

Eklem Hastalik Cerrahisi

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Section: Discussionmentioning

confidence: 99%

Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits

Taşkesen

Ataoğlu

Özer

et al. 2015

Eklem Hastalik Cerrahisi

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“…During the early postoperative period, the weakest link is the tendon-bone interface, which does not regenerate into the fibrocartilaginous-type entheses seen in the native ACL insertion site [19][20][21]. Research on methods of enhancing and accelerating tendon-to-bone healing is ongoing; these methods include the application of periosteum augmentation, BMP, calcium-phosphate cement, granulocyte colony-stimulating factor, gene transfer, and so on [22][23][24], all of which may reduce the time required before the return to competitive sports, work, and other daily activities. Rodeo et al [25] demonstrated a correlation between tendon-bone interface strength and the degree of bone ingrowth, HPC, a non-ionic and water-soluble polymer, is widely used in pharmaceutical and cosmetic formulations.…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Jiang

et al. 2012

International Orthopaedics (SICOT)

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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.

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“…For better tendon bone healing, previous study had showed that when ACL reconstruction with the periosteum-enveloped tendon, the periosteum could form the fibrocartilage at the interface of tendon graft and bone tunnel with its progenitor cell in rabbit model. [16,17] The periosteum consists of multipotent mesodermal cells that are capable of differentiating into various types of connective tissue and bone. [11,12] Experimental studies have revealed that progenitor cells in free periosteal grafts will be inducted by surrounding tissue.…”

Section: Discussionmentioning

confidence: 99%

“…[1,11] Previous studies revealed that periosteal tissue may enhance healing of the interface between the tendon and the bone by forming fibrocartilage and calcified fibrocartilage. [16,17] In clinical study, periosteum could enhance tendon-bone healing in ACL reconstruction with satisfactory clinical outcome. [18] The progenitor cells of periosteal cambial layer (PPC) may be used to enhance the healing process.…”

mentioning

confidence: 99%

Bioengineered Periosteal Progenitor Cell Sheets to Enhance Tendon‑Bone Healing in A Bone Tunnel

Chang¹,

Chen²,

Liu³

et al. 2012

Biomedical

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Original Article At a Glance Commentary Scientific background of the subjectTendon-bone tunnel healing is one of the key factors for successful anterior cruciate ligament reconstruction. For better and quicker tendon-bone healing, many materials have been used to augment or enhance the tendon-bone healing process. A bioengineered periosteal progenitor cell sheet without scaffolds was created to enhance tendon-bone tunnel healing. What this study adds to the fieldPeriosteal progenitor cell monolayer maintains the differentiated and osteochondral potential to promote fibrocartilage and bone formation in tendon-bone junction. A periosteal progenitor cell sheet was developed to promote tendon-bone interface integration and healing. Bioengineered periosteal progenitor cell sheets provide a novel strategy to enhance tendon-bone healing in anterior cruciate ligament reconstruction.Background: Tendon-bone tunnel healing is crucial for long term success in anterior cruciate ligament (ACL) reconstruction. The periosteum contains osteochondral progenitor cells that can differentiate into osteoblasts and chondroblasts during tendon-bone healing. We developed a scaffold-free method using polymerized fibrin-coated dishes to make functional periosteal progenitor cell (PPC) sheets. Bioengineered PPC sheets for enhancing tendon-bone healing were evaluated in an extra-articular bone tunnel model in rabbit. Methods:PPC derived from rabbit tibia periosteum, cultivated on polymerized fibrin-coated dishes and harvested as PPC sheet. A confocal microscopy assay was used to evaluate the morphology of PPC sheets. PPC sheets as a periosteum to wrap around hamstring tendon grafts were pulled into a 3-mm diameter bone tunnel of tibia, and compared with a tendon graft without PPC sheets treatment. Rabbits were sacrificed at 4 and 8 weeks postoperatively for biochemical assay and histological assay to demonstrate the enhancement of PPC sheets in tendon-bone healing. Results:PPC spread deposit on fibrin on the dish surface with continuous monolayer PPC was observed. Histological staining revealed that PPC sheets enhance collagen and glycosaminoglycans deposition with fibrocartilage formation in the tendon-bone junction at 4 weeks. Collagen fiber with fibrocartilage formation at tendon-bone junction was also found at 8 weeks. Matured fibrocartilage and dense collagen fiber were formed at the tendon-bone interface at 8 weeks by Masson trichrome and Safranin-O staining. Conclusions: Periosteal progenitor cell monolayer maintains the differentiated capacity and osteochondral potential in order to promote fibrocartilage formation in tendon-bone junction. Bioengineered PPC sheets can offer a new feasible therapeutic strategy of a novel approach to enhance tendon-bone junction healing. (Biomed J 2012;35:473-80)

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Enveloping the tendon graft with periosteum to enhance tendon-bone healing in a bone tunnel: A biomechanical and histologic study in rabbits

Cited by 94 publications

References 11 publications

Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits

Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits

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

Bioengineered Periosteal Progenitor Cell Sheets to Enhance Tendon‑Bone Healing in A Bone Tunnel

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