Augmentation of tendon healing in an intraarticular bone tunnel with use of a bone growth factor.
We hypothesized that an exogenous bone growth factor could augment healing of a tendon graft in a bone tunnel in a rabbit anterior cruciate ligament-reconstruction model. Seventy rabbits underwent bilateral anterior cruciate ligament reconstructions with a semitendinosus tendon graft. One limb received a collagen sponge carrier vehicle containing a mixture of bone-derived proteins while the contralateral limb was treated with either no sponge or a sponge without bone-derived proteins. The reconstruction was evaluated at 2, 4, or 8 weeks with histologic, biomechanical, and magnetic resonance imaging analysis. Histologic analysis demonstrated that specimens treated with bone-derived proteins had a more consistent, dense interface tissue and closer apposition of new bone to the graft, with occasional formation of a fibrocartilaginous interface, when compared with control specimens. The treated specimens had significantly higher load-to-failure rates than did control specimens. Treatment with bone-derived proteins resulted in an average increase in tensile strength of 65%. The treated specimens were stronger than control specimens at each time point, but the difference was greatest at 8 weeks. On the basis of signal characteristics and new bone formation, magnetic resonance imaging was useful for predicting which limb was treated, the site of failure, and the limbs with higher load-to-failure values. This study demonstrates the potential for augmenting tendon healing in an intraarticular bone tunnel using an osteoinductive growth factor.
Anderson
K
K
William Clay Ford Center for Athletic Medicine, Detroit, Michigan 48202, USA.
Seneviratne
A M
AM
Izawa
K
K
Atkinson
B L
BL
Potter
H G
HG
Rodeo
S A
SA
D000818:Animals; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D006614:Hindlimb / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D011817:Rabbits; D013710:Tendons / Q000637:transplantation*; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology*
D019485:Bone Morphogenetic Proteins