title: Revascularisation pattern of ruptured flexor tendon grafts in anterior cruciate ligament reconstruction: A histological study.
abstract: BACKGROUND
  For successful anterior cruciate ligament (ACL) reconstruction, revascularisation and histological maturation are necessary, as their failure can cause graft rupture.
  
  
  OBJECTIVE
  The purpose of this study was to describe differences in the histological maturation of early failed plasty (less than 12 months after surgery) and late failed plasty (more than 12 months after surgery) in patients with re-rupture after ACL reconstruction with hamstring tendons.
  
  
  METHODS
  A descriptive observational study was conducted on a consecutive series of 20 patients whose ACL reconstruction had failed. Graft biopsy samples were obtained during the revision surgery from the proximal, medial, and distal graft remnants. The samples were evaluated by light microscopy, and the vascularity and maturation of the samples were established by histological scoring.
  
  
  RESULTS
  The most common aetiology of reconstruction failure (86.6%) was a specific event with non-contact mechanism. The patients with re-rupture of their ACL plasty less than 12 months after surgery had substance vessels that were less deep. The distal segment of the graft in those patients showed a delay in histological maturation with fewer collagen fibres.
  
  
  CONCLUSIONS
  In patients whose ACL grafts failed less than 12 months after surgery, a lower distribution of blood vessels and collagen fibres was found that were less ordered in the distal graft. These results indicate a delay in maturation, which leads to a higher risk of graft failure.
authors.affiliation: Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
authors.forename: D
authors.initials: D
authors.lastname: Figueroa
authors.affiliation: Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile. Electronic address: doctormartinez@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Martínez
authors.affiliation: Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
authors.forename: R
authors.initials: R
authors.lastname: Calvo
authors.affiliation: Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
authors.forename: M
authors.initials: M
authors.lastname: Scheu
authors.affiliation: Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
authors.forename: M
authors.initials: M
authors.lastname: Gallegos
authors.affiliation: Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
authors.forename: A
authors.initials: A
authors.lastname: Vaisman
authors.affiliation: Facultad de Medicina, Clínica Alemana - Universidad del Desarrollo, Santiago, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Martínez
authors.affiliation: Instituto de Química, Universidad de Valparaíso, Valparaíso, Chile.
authors.forename: A
authors.initials: A
authors.lastname: González
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D016037:Single-Blind Method; D013708:Tendon Injuries / Q000209:etiology* / Q000473:pathology; D013710:Tendons / Q000098:blood supply* / Q000473:pathology / Q000637:transplantation*; D017211:Treatment Failure
keywords: Anterior cruciate ligament; Fail; Fallo; Histology; Histología; Ligamento cruzado anterior; Maduración; Maturation; Reconstrucción; Reconstruction; Revascularisation; Revascularización