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Therapeutic advantage in selective ligament augmentation for partial tears of the anterior cruciate ligament: Results in an animal model

Mifune, Y and Ota, S and Takayama, K and Hoshino, Y and Matsumoto, T and Kuroda, R and Kurosaka, M and Fu, FH and Huard, J (2013) Therapeutic advantage in selective ligament augmentation for partial tears of the anterior cruciate ligament: Results in an animal model. American Journal of Sports Medicine, 41 (2). 365 - 373. ISSN 0363-5465

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Abstract

Background: As a result of recent studies describing the double-bundle anterior cruciate ligament (ACL), selected ACL augmentation procedures, either anteromedial (AM) or posterolateral (PL), have been introduced as the treatment of choice for partial ACL ruptures. The preserved mechanoreceptor and vascularity of the remnant ACL are considered to provide additional biological benefits. Although enhanced knee joint proprioception in ACL augmented patients has been previously reported, there is no study assessing biological healing advantages of the graft after the ACL augmentation procedure. Hypothesis: Selected ACL augmentation for partial tears can accelerate the healing process of the grafted tendon, which promotes better biomechanical recovery of the tendon, compared with conventional ACL reconstruction of complete tears. Study Design: Controlled laboratory study. Methods: Two rat models were established in this study: an ACL augmentation partial tear model and conventional ACL reconstruction for a complete tear. Biological assessments of cellularity and angiogenesis were measured by hematoxylin and eosin staining and immunostaining, respectively. Additionally, rat-specific type III collagen and a-smooth muscle actin were evaluated by immunohistochemical staining to analyze the healing process, whereas anti-rat neurofilament antigen was assessed to examine proprioceptive recovery. Biological assessments of the augmented and reconstructed grafts were conducted postoperatively at week 2, whereas biomechanical testing was performed postoperatively at week 8. Results: An increase in cellularity and angiogenesis was observed in the augmented grafts compared with the conventionally reconstructed grafts. Also, increased amounts of rat-specific type III collagen, a-smooth muscle actin, and anti-rat neurofilament antigen were expressed in the augmented grafts. Biomechanical testing showed that failure to load was significantly higher in the augmentation group compared with the conventional reconstruction group (augmentation, 15.9 ± 1.0; reconstruction, 7.0 ± 1.3; P<.01). Clinical Relevance: Selected ACL augmentation could be a good choice for the repair of partial ACL injury by preserving the uninjured portion of the ACL, which in turn could maintain the anatomic position of the ligament and its biomechanical function. © 2012 The Author(s).


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mifune, Y
Ota, S
Takayama, K
Hoshino, Y
Matsumoto, T
Kuroda, R
Kurosaka, M
Fu, FHffu@pitt.eduFFU
Huard, J
Centers: Other Centers, Institutes, or Units > Stem Cell Research Center
Date: 1 February 2013
Date Type: Publication
Journal or Publication Title: American Journal of Sports Medicine
Volume: 41
Number: 2
Page Range: 365 - 373
DOI or Unique Handle: 10.1177/0363546512471614
Schools and Programs: School of Medicine > Orthopaedic Surgery
Refereed: Yes
ISSN: 0363-5465
PubMed ID: 23299851
Date Deposited: 31 Mar 2014 15:23
Last Modified: 03 Feb 2019 10:55
URI: http://d-scholarship.pitt.edu/id/eprint/20814

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