Establishment of near and non isometric anterior cruciate ligament reconstruction with artificial ligament in a rabbit model

Abstract

Background Tunnel position deicide the isometry of graft attachment in synthetic anterior cruciate ligament (ACL) reconstruction. Near-isometric tunnel position may have advantage in graft integration and knee function in ACL reconstruction (ACLR) with polyethylene terephthalate (PET) ligament. Few studies focused on tunnel position isometry when conduct ACLR with an animal model. This study aimed to establish a preclinical rabbit model of near and non isometric ACLR with PET ligament and investigate the advantage of near-isometric ACLR compared to non-isometric ACLR. Methods Nine hind limbs of rabbit were used in tunnel position study. Two femoral(anatomic, nonanatomic) tunnels and three tibial(anterior, middle, posterior) tunnels were used to measure tunnel position isometry during knee full range of motion. The tunnel position combination with minimal isometry was considered as near-isometric tunnel position. Then, 48 rabbits divided into two groups were conducted near or non isometric ACLR with PET ligament with graft fixation angle of 30° and constant tension of 5N. PET ligament isometry, range of motion(ROM) restriction, knee laxity were recorded after operation and followed up with macroscopic observation, microcomputed tomography (micro-CT) analysis, histology assessment and biomechanical test at 4 and 8 weeks postoperatively. Results The tunnel combination with minimal isometry was femoral anatomic position and tibial posterior position(5.19 ​± ​1.78%) and considered as near-isometric tunnel position. ROM restriction were observed in non-isometric group (22.50 ​± ​14.14°) while none in near-isometric group. However, no ROM restriction observed at 8 weeks in both group. Knee laxity compared to contralateral knee were better in near-isometric group than non-isometric group (stable/slack/total 10/2/12 VS 3/9/12, p ​= ​0.012) at 8 weeks postoperatively. Supeiror PET ligament integration were also observed in near-isometric group through macroscopic observation, micro-CT analysis, histology assessment at both 4 and 8 weeks. The failure load in the Near-Isometric group at 8 weeks were higher than timezero reconstruction with statistical difference (156.8N ​± ​25.98N vs.102.6 ​± ​22.96N, p ​= ​0.02). Conclusion A rabbit model of ACLR based on tunnel position isometry was successfully established in this study. The near-isometric tunnel position in rabbit model was femoral anatomic position and tibial posterior position. A near-isometric ACLR with PET ligament did not cause ROM restriction and had a better graft integration and follow-up stability than non-isometric ACLR with ROM restriction. The Translational Potential of this Article The study demonstrate the establishmentof near-isometric tunnel position and non-isometric tunnel position with significant difference of ROM restriction and graft-bone integration. The described tunnel positions with differential isometry in a rabbi...

The early infection characterization of septic arthritis by Staphylococcus aureus after anterior cruciate ligament reconstruction in a novel rat model

“…The weaved autograft was introduced into bone tunnels and fixed by 1.6 mm (diameter) interference screws (M1.6, Guwanji company, China) (Fig. 2 E) with the knee flexed to 30° pretensioned at a load of 5 N [ 17 , 21 , 22 ] (Fig. 2 F).…”

The early infection characterization of septic arthritis by staphylococcus aureus after anterior cruciate ligament reconstruction in a novel rat model

“…The weaved autograft was introduced into bone tunnels and xed by 1.6 mm (diameter) interference screws (Figs. 2E) with the knee exed to 30° pretensioned at a load of 5 N [16, 19,20] (Figs. 2F).…”

Application of Nondegradable Synthetic Materials for Tendon and Ligament Injury

“…Jin et al established a preclinical rabbit model for near and non-isometric ACLR using PET ligaments, with a focus on tunnel position isometry. [121] The near-isometric tunnel position was identified as the femoral anatomic position and tibial posterior position, which resulted in superior graft integration, follow-up stability, and no range of motion (ROM) restriction compared to non-isometric ACLR. The established rabbit model enables preclinical research into tunnel position isometry and its effect on various grafts, graft integration, and knee function, offering a reproducible and translational small animal model for future investigation.…”