title: Periosteal augmentation of a tendon graft improves tendon healing in the bone tunnel.
abstract: Secure fixation of tendon or ligament to bone has been a challenging problem. The periosteum is an osteogenic organ that regulates bone growth and remodeling at the outer surface of cortical bone and also is known to play an important role in forming a tendon insertion site to bone. Therefore, we hypothesized that a freshly harvested periosteum can be used as a stimulative scaffold to biologically reinforce the attachment of tendon graft to bone. Using a rabbit hallucis longus tendon and calcaneus process model, we found that a periosteal augmentation of a tendon graft could enhance the structural integrity of the tendon-bone interface, when the periosteum is placed between the tendon and bone interface with the cambium layer facing toward the bone. Clinically, the use of an autogenous periosteum patch would be an optimal choice for biologic augmentation of the tendon graft in the bone tunnel, because the tissue is readily available for harvest from the patient's body.
authors.affiliation: Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118, USA.
authors.forename: Inchan
authors.initials: I
authors.lastname: Youn
authors.forename: Deryk G
authors.initials: DG
authors.lastname: Jones
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Andrews
authors.forename: Marcus P
authors.initials: MP
authors.lastname: Cook
authors.forename: J-K Francis
authors.initials: JK
authors.lastname: Suh
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001696:Biomechanical Phenomena; D002111:Calcaneus / Q000601:surgery; D004195:Disease Models, Animal; D006085:Graft Survival; D007150:Immunohistochemistry; D008297:Male; D010521:Periosteum / Q000637:transplantation*; D011336:Probability; D011817:Rabbits; D012680:Sensitivity and Specificity; D013710:Tendons / Q000473:pathology* / Q000637:transplantation*; D013718:Tensile Strength; D014945:Wound Healing / Q000502:physiology