Peri-tunnel bone loss: does it affect early tendon graft to bone tunnel healing after ACL reconstruction?

Abstract

There was time-dependent loss of peri-tunnel bone early post-reconstruction, with the greatest loss occurring at the tibial metaphysis. This was consistent with high expression of MMP1, MMP13 and CD68+ cells at the graft-bone tunnel interface and the peri-tunnel region. The significant loss of peri-tunnel bone, though not critically affecting early tunnel healing, suggested the need to protect the knee joint early post-reconstruction.

Correlation between fixation systems elasticity and bone tunnel widening after ACL reconstruction

“…It shows that peri-implant bone resorbtion a time-depending process, sustained by metalloprotease and CD68+ cells within 6 weeks 28 . Therefore is possible to state, as for graft healing process 29 , that femoral and tibial bone tunnel enlargement comes from a balance between biological factors and biomechanical factors.…”

Biodegradable Magnesium Screws Accelerate Fibrous Tissue Mineralization at the Tendon-Bone Insertion in Anterior Cruciate Ligament Reconstruction Model of Rabbit

“…As the low production of artifact caused by the Ti hardware on imaging did not significantly alter the bone related parameters (Supplementary Table S1), including BV/TV (Ti implantation vs. Ti removal: 0.354 ± 0.026 vs. 0.337 ± 0.062, P  = 0.496) and BMD (1.882 ± 0.027 vs. 1.881 ± 0.009, P  = 0.842), CT analysis was suitable for the assessment of temporal change of peri-tunnel bone quality in both Mg and Ti groups. The peri-tunnel bone mass, which is commonly reduced after ACL reconstruction in both preclinical and clinical cases39, was also observed deterioration in both Mg and Ti groups after surgery, which may be ascribed to the promoted expression of MMP1, MMP13 and CD68+ cells at the peri-tunnel region during the graft healing stage40. The peri-tunnel bone loss mainly occurred within the initial 12 weeks after surgery, indicating that 12 weeks postsurgically is the critical time point affecting knee function restoration.…”

Exosomes derived from magnetically actuated bone mesenchymal stem cells promote tendon-bone healing through the miR-21-5p/SMAD7 pathway

“…In general, peri-tunnel bone loss after ACLR is commonly observed in both clinical and pre-clinical studies, which might adversely affect the tendon graft enthesis mineralization and result in a less stable surface for tendon-bone integration [ 75 , 76 ]. Based on previous studies, SMF or IONPs, delivered alone or in combination, could enhance osteogenesis, inhibit osteoclastogenesis, and enhance the stability of the bone tunnel healing surface [ [45] , [46] , [47] , 49 , 77 , 78 ].…”