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Zheng T, Du L, Chu Z, Li L, Li B, Zhang B, Li X, Liu P, Lu Q. Unicompartmental knee arthroplasty combined with posterior cruciate ligament reconstruction: a case report. BMC Musculoskelet Disord 2024; 25:370. [PMID: 38730370 PMCID: PMC11088125 DOI: 10.1186/s12891-024-07492-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND In this study, we present the unique case of a patient with knee osteoarthritis (OA) of the medial compartment and posterior cruciate ligament (PCL) deficiency who underwent simultaneous medial unicompartmental knee arthroplasty (UKA) and PCL reconstruction. CASE PRESENTATION A 49-year-old male patient presented with a 1-year history of pain and instability in the left knee. The patient had previously experienced a trauma-related injury to the PCL of the left knee that was left untreated. Imaging and physical examination confirmed the presence of left medial knee OA along with PCL rupture. To address these issues, the patient underwent UKA combined with PCL reconstruction. The patient's Lysholm score was 47 before surgery and 81 three months after surgery, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was 29 before surgery and 18 three months after surgery, and the International Knee Documentation Committee (IKDC) subjective score was 56.3 before surgery and 74.7 three months after surgery. Six months after surgery, the patient's gait returned to normal, and he was able to jog. CONCLUSION This case report presents the first instance of UKA combined with PCL reconstruction and introduces a novel treatment approach for patients suffering from medial knee OA and ligament injury.
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Affiliation(s)
- Tong Zheng
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250102, China
| | - Longzhuo Du
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250102, China
| | - Ziyue Chu
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250102, China
| | - Lei Li
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250102, China
| | - Binglong Li
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
- Cheeloo College of Medicine, Shandong University, Jinan, 250102, China
| | - Baoqing Zhang
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
| | - Xuezhou Li
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
| | - Peilai Liu
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China
| | - Qunshan Lu
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China.
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Ma L, Dong W, Lai E, Wang J. Silk fibroin-based scaffolds for tissue engineering. Front Bioeng Biotechnol 2024; 12:1381838. [PMID: 38737541 PMCID: PMC11084674 DOI: 10.3389/fbioe.2024.1381838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
Silk fibroin is an important natural fibrous protein with excellent prospects for tissue engineering applications. With profound studies in recent years, its potential in tissue repair has been developed. A growing body of literature has investigated various fabricating methods of silk fibroin and their application in tissue repair. The purpose of this paper is to trace the latest developments of SF-based scaffolds for tissue engineering. In this review, we first presented the primary and secondary structures of silk fibroin. The processing methods of SF scaffolds were then summarized. Lastly, we examined the contribution of new studies applying SF as scaffolds in tissue regeneration applications. Overall, this review showed the latest progress in the fabrication and utilization of silk fibroin-based scaffolds.
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Affiliation(s)
- Li Ma
- National Innovation Center for Advanced Medical Devices, Shenzhen, China
| | - Wenyuan Dong
- National Innovation Center for Advanced Medical Devices, Shenzhen, China
| | - Enping Lai
- College of Biological and Chemical Engineering, Guangxi University of Science and Technology, Liuzhou, China
| | - Jiamian Wang
- National Innovation Center for Advanced Medical Devices, Shenzhen, China
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Meyer DC, Bachmann E, Darwiche S, Moehl A, von Rechenberg B, Gerber C, Snedeker JG. Rotator Cuff Repair and Overlay Augmentation by Direct Interlocking of a Nonwoven Polyethylene Terephthalate Patch Into the Tendon: Evaluation in an Ovine Model. Am J Sports Med 2023; 51:3235-3242. [PMID: 37681526 DOI: 10.1177/03635465231189802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
BACKGROUND Arthroscopic repair of large rotator cuff tendon tears is associated with high rates of retear. Construct failure often occurs at the suture-tendon interface. Patch augmentation can improve mechanical strength and healing at this interface. PURPOSE To introduce a novel technique for suture-free attachment of an overlaid patch and evaluate its biomechanical strength and biological performance. STUDY DESIGN Descriptive and controlled laboratory studies. METHODS An established ovine model of partial infraspinatus tendon resection and immediate repair was used. After a nonwoven polyethylene terephthalate patch was overlaid to the resected tendon, a barbed microblade was used to draw fibers of the patch directly into the underlying tissue. In vivo histological assessment of healing was performed at 6 and 13 weeks after implantation. Ex vivo models were used to characterize primary repair strength of the suture-free patch fixation to tendon. Additional ex vivo testing assessed the potential of the technique for patch overlay augmentation of suture-based repair. RESULTS The in vivo study revealed no macroscopic evidence of adverse tissue reactions to the interlocked patch fibers. Histological testing indicated a normal host healing response with minimal fibrosis. Uniform and aligned tissue ingrowth to the core of the patch was observed from both the tendon and the bone interfaces to the patch. There was no evident retraction of the infraspinatus muscle, lengthening of the tendon, or tendon gap formation over 13 weeks. Ex vivo testing revealed that direct patch interlocking yielded tendon purchase equivalent to a Mason-Allen suture (150 ± 58 vs 154 ± 49 N, respectively; P = .25). In an overlay configuration, fiber interlocked patch augmentation increased Mason-Allen suture retention strength by 88% (from 221 ± 43 N to 417 ± 86 N; P < .01) with no detectable difference in repair stiffness. CONCLUSION Testing in an ovine model of rotator cuff tendon repair suggested that surgical interlocking of a nonwoven medical textile can provide effective biomechanical performance, support functional tissue ingrowth, and help avoid musculotendinous retraction after surgical tendon repair. CLINICAL RELEVANCE The novel technique may facilitate patch augmentation of rotator cuff repairs.
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Affiliation(s)
- Dominik C Meyer
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Elias Bachmann
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- ZuriMED Technologies AG, Zurich, Switzerland
| | - Salim Darwiche
- Musculoskeletal Research Unit, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland
| | | | - Brigitte von Rechenberg
- Musculoskeletal Research Unit, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland
| | - Christian Gerber
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jess G Snedeker
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
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Therrien E, Pareek A, Song BM, Wilbur RR, Till SE, Krych AJ, Stuart MJ, Levy BA. Comparison of Posterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement. Orthop J Sports Med 2022; 10:23259671221137357. [PMID: 36479468 PMCID: PMC9720802 DOI: 10.1177/23259671221137357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background Biomechanical studies support the use of suture tape reinforcement for limiting graft elongation and increasing strength in knee ligament reconstructions. Purpose To compare posterior cruciate ligament (PCL) laxity, complication and reoperation rates, and patient-reported outcomes (PROs) after all-inside single-bundle PCL reconstruction (PCLR) with versus without independent suture tape reinforcement. Study Design Cohort study; Level of evidence, 3. Methods A retrospective cohort study of consecutive patients who underwent primary, all-inside allograft single-bundle PCLR with and without independent suture tape reinforcement at a single academic institution from 2012 to 2019. Medical records were reviewed for patient characteristics, additional injuries, and concomitant procedures. PRO scores (including the International Knee Documentation Committee [IKDC], Tegner activity scale, and Lysholm scores), bilateral comparison kneeling radiographs, and physical examination findings were collected at a minimum of 2 years postoperatively. Results Included were 50 patients: 19 with suture tape reinforcement (mean age 30.6 ± 2.9 years) and 31 without suture tape reinforcement (control group; mean age 26.2 ± 1.6 years). One PCLR graft in the suture tape group failed. Posterior drawer examination revealed grade 1+ laxity in 4 of 19 (21%) of the suture tape cohort versus 6 of 31 (19%) of the control cohort (P > .999). Bilateral kneeling radiographs showed similar side-to-side differences in laxity between the groups (suture tape vs control: mean, 1.9 ± 0.4 vs 2.6 ± 0.6 mm; P = .361). There were no statistically significant differences between the groups in postoperative IKDC (suture tape vs control: 79.3 vs 79.6; P = .779), Lysholm (87.5 vs 84.3; P = .828), or Tegner activity (5.6 vs 5.7; P = .562) scores. Conclusion All-inside single-bundle PCLR with and without independent suture tape reinforcement demonstrated low rates of graft failure, complications, and reoperations, with satisfactory PROs at a minimum 2-year follow-up. Radiographic posterior tibial translation was comparable between the 2 groups.
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Affiliation(s)
- Erik Therrien
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Ayoosh Pareek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Bryant M. Song
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Ryan R. Wilbur
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Sara E. Till
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron J. Krych
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J. Stuart
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Bruce A. Levy
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA. ,Bruce A. Levy, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA ()
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Li J, Xue C, Wang H, Dong S, Yang Z, Cao Y, Zhao B, Cheng B, Xie X, Mo X, Jiang W, Yuan H, Pan J. Hybrid Nanofibrous Composites with Anisotropic Mechanics and Architecture for Tendon/Ligament Repair and Regeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2201147. [PMID: 35686342 DOI: 10.1002/smll.202201147] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/12/2022] [Indexed: 06/15/2023]
Abstract
Rupture of tendons and ligaments (T/L) is a major clinical challenge due to T/L possess anisotropic mechanical properties and hierarchical structures. Here, to imitate these characteristics, an approach is presented by fabricating hybrid nanofibrous composites. First, hybrid fiber-reinforced yarns are fabricated via successively electrospinning poly(L-lactide-co-ε-caprolactone) (PLCL) and gelatin (Ge) nanofibers onto polyethylene terephthalate (PET) fibers to improve biodurability and biocompatibility. Then, by comparing different manufacturing methods, the knitted structure succeeds in simulating anisotropic mechanical properties, even being stronger than natural ligaments, and possessing comfort compliance superior to clinically used ligament advanced reinforcement system (LARS) ligament. Moreover, after inoculation with tendon-derived stem cells and transplantation in vivo, hybrid nanofibrous composites are integrated with native tendons to guide surrounding tissue ingrowth due to the highly interconnected and porous structure. The knitted hybrid nanofibrous composites are also ligamentized and remodeled in vivo to promote tendon regeneration. Specifically, after the use of optimized anisotropic hybrid nanofibrous composites to repair tendon, the deposition of tendon-associated extracellular matrix proteins is more significant. Thus, this study indicates a strategy of manufacturing anisotropic hybrid nanofibrous composites with superior mechanical properties and good histocompatibility for clinical reconstruction.
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Affiliation(s)
- Jun Li
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Chao Xue
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Hao Wang
- Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, P. R. China
| | - Shiyan Dong
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA
| | - Zhaogang Yang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA
| | - Yuting Cao
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P. R. China
| | - Binan Zhao
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Biao Cheng
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
| | - Xianrui Xie
- School of Pharmacy, Key Laboratory of Prescription Effect and Clinical Evaluation of State Administration of Traditional Chinese Medicine of China, Binzhou Medical University, Yantai, 264003, P. R. China
| | - Xiumei Mo
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, 201620, P. R. China
| | - Wen Jiang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA
| | - Hengfeng Yuan
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P. R. China
| | - Jianfeng Pan
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, P. R. China
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Posterior cruciate ligament reconstruction with independent internal brace reinforcement: surgical technique and clinical outcomes with a minimum two year follow-up. INTERNATIONAL ORTHOPAEDICS 2022; 46:2019-2028. [PMID: 35616654 PMCID: PMC9372122 DOI: 10.1007/s00264-022-05448-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/12/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE We developed an augmentation technique for PCL reconstruction with independent internal brace reinforcement and evaluated the functional outcome after PCL reconstruction employing autologous hamstrings augmented with an internal brace system for patients with isolated or combined grade 3 posterior instability who were treated with this technique. METHODS From January 2016 to January 2018, patients with isolated or combined grade 3 PCL tears who underwent single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces were studied. The function of the operated knee was evaluated according to the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity score. The patients were asked the level of returned to their previous sport. Posterior knee laxity was examined with a KT-1000 arthrometer, and data on range of motion (ROM), re-operation, and other complications were collected. RESULTS A total of 33 consecutive patients who received single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces with a minimum two years follow-up were included in this study. Two patients had undergone this procedure during the study period and were not included in this study (one had combined bone fractures, and one patient had previous meniscus surgery). Thirty-one patients were available for final analysis. The mean follow-up was 45.35 ± 10.88 months (range 29-66 months). The average IKDC subjective knee evaluation scores from 51.65 ± 12.35 to 84.52 ± 6.42, the Lysholm score from 53.90 ± 11.86 to 85.68 ± 4.99, and the Tegner score from 2.81 ± 0.79 to 6.71 ± 1.83 (P < 0.05 for all). The mean total posterior side-to-side difference in knee laxity, assessed using a KT-1000 arthrometer, decreased from 12.13 ± 2.66 mm pre-operatively to 1.87 ± 0.56 mm post-operatively at 70° (P < 0.05). Most patients (29/31) had normal or near normal knee ROM post-operatively; two patients revealed a 6-15° loss of knee flexion compared with the contralateral knee. Twenty-nine patients (93.55%) returned to a normal daily exercise level. Twenty-three patients (74.19%) returned to competitive sports with high-level sports (Tegner score of 6 or above; eleven patients (35.48%) reported to be on the same level as well as the Tegner level); six patients (19.35%) returned to recreational sports (Tegner score of 4 or 5). Two patients had Tegner scores of 2 and 3, indicating poor function level. No patient needed PCL revision surgery during the follow-up period. CONCLUSION Single-bundle PCL reconstruction with internal brace augmentation for PCL injury exhibited satisfactory posterior stability and clinical outcomes in patients with isolated or combined grade 3 PCL injuries at a minimum two year follow-up.
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McDonald LK, Cosic F, Joseph S. The use of the ligament augmentation and reconstruction system for posterior cruciate ligament reconstruction in isolated and multiligament knee injuries: A systematic review. Knee 2021; 30:322-336. [PMID: 34029853 DOI: 10.1016/j.knee.2021.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/11/2021] [Accepted: 04/09/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of the Ligament Augmentation and Reconstruction System (LARS) in posterior cruciate ligament (PCL) reconstruction in isolated PCL injuries and multiligament knee injuries, analysing clinical, radiographic, and patient reported outcome measures (PROMs). METHODS A systematic review according to PRISMA guidelines was performed through Embase via Ovid, PubMed, and the Cochrane Library to identify studies reviewing LARS use for PCL reconstruction. The methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. RESULTS From 225 results screened, 13 studies were included published between 2004 and 2020, analysing LARS use for PCL reconstruction. Mean follow-up was 21 months to 11.9 years, however only four studies had follow-up of over five years. Results in isolated PCL reconstruction utilising LARS demonstrated scores that were consistent with good function and minimal limitation in daily or sporting activities, in addition to a significant improvement in knee laxity and low complication rates. Symptomatic rupture and synovitis rates were both 1.7% in this group. LARS use in complex multiligament injuries demonstrated satisfactory PROMs, although there was concern regarding residual laxity on stress radiography. CONCLUSIONS LARS demonstrates good outcomes in PCL injury reconstruction in the short to mid-term, particularly in isolated PCL injuries, achieving equivocal or improved results compared to autograft reconstruction using hamstring tendon in the three comparative studies included. LARS has a quicker recovery time and no donor-site morbidity, however long-term data is lacking. Utilising LARS for reconstruction of the PCL in multiligament injuries revealed more variable results.
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Affiliation(s)
| | - Filip Cosic
- Alfred Health, Melbourne, Victoria, Australia
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Panagopoulos A, Solou K, Kitrou PM, Kouzelis A, Kokkalis ZT, Triantafyllopoulos IK. Injury to the Medial Superior Genicular Artery After Isolated Posterior Cruciate Ligament Reconstruction: A Case Report. JBJS Case Connect 2021; 11:e20.00371. [PMID: 33502137 DOI: 10.2106/jbjs.cc.20.00371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 19-year-old male patient with isolated posterior cruciate ligament (PCL) rupture underwent arthroscopic reconstruction using reinforced synthetic ligament (LARS system). Three weeks postoperatively, he presented with active bleeding from the medial side of his knee, near the proximal interference screw. An angiogram revealed extravasation from the medial superior genicular artery which was successfully embolized. One week later, he returned with active bleeding from the same area, located just under the initial coiling; a second embolization during superselective angiography was successful. CONCLUSION Although rare, minor vascular injuries are a risk inherent to PCL surgery.
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Affiliation(s)
| | | | - Panagiotis M Kitrou
- Department of Diagnostic and Interventional Radiology, Patras University Hospital, Patras, Greece
| | - Antonis Kouzelis
- Orthopaedic Department, Patras University Hospital, Patras, Greece
| | - Zinon T Kokkalis
- Orthopaedic Department, Patras University Hospital, Patras, Greece
| | - Ioannis K Triantafyllopoulos
- Laboratory for the Research of Musculoskeletal System "Th. Garofalidis," Medical School, National and Kapodistrian University of Athens.,5th Orthopaedic Department, HYGEIA Private Hospital, Athens, Greece
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Deal JB, Allen DC, Bottoni CR. Anatomic Double Bundle Posterior Cruciate Ligament Reconstruction Using an Internal Splint. Arthrosc Tech 2020; 9:e729-e736. [PMID: 32577345 PMCID: PMC7301276 DOI: 10.1016/j.eats.2020.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/04/2020] [Indexed: 02/03/2023] Open
Abstract
Techniques for reconstruction of posterior cruciate ligament (PCL) tears are rapidly evolving. One problem with current techniques is that laxity may develop early in the postoperative period, leading to relapsed posterior translation of the tibia. Therefore, maintaining tibial reduction during graft incorporation is a target for improvement. We describe using an internal splint to optimize the 4-tunnel, double-bundle allograft PCL reconstruction.
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Affiliation(s)
| | - Dexter C. Allen
- Address correspondence to Dexter C. Allen, M.D. CPT, USA, 1 Jarrett White Rd, Honolulu, HI 96859, U.S.A.
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Sun J, Wei XC, Li L, Cao XM, Li K, Guo L, Lu JG, Duan ZQ, Xiang C, Wei L. Autografts vs Synthetics for Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. Orthop Surg 2020; 12:378-387. [PMID: 32180364 PMCID: PMC7189042 DOI: 10.1111/os.12662] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 01/14/2023] Open
Abstract
To describe the outcomes of autografts and synthetics in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction with respect to instrumented laxity measurements, patient‐reported outcome scores, complications, and graft failure risk. We searched PubMed, Cochrane Library, and EMBASE for published randomized controlled trials (RCT) and case controlled trials (CCTs) to compare the outcomes of the autografts versus synthetics after cruciate ligament reconstruction. Data analyses were performed using Cochrane Collaboration RevMan 5.0. Nine studies were identified from the literature review. Of these studies, three studies compared the results of bone–patellar tendon–bone (BPTB) and ligament augmentation and reconstruction system (LARS), while six studies compared the results of four‐strand hamstring tendon graft (4SHG) and LARS. The comparative study showed no difference in Lysholm score and failure risk between autografts and synthetics. The combined results of the meta‐analysis indicated that there was a significantly lower rate of side‐to‐side difference > 3 mm (Odds Ratio [OR] 2.46, 95% confidence intervals [CI] 1.44–4.22, P = 0.001), overall IKDC (OR 0.40, 95% CI 0.19–0.83, P = 0.01), complications (OR 2.54, 95% CI 1.26–5.14, P = 0.009), and Tegner score (OR −0.31, 95% CI −0.52–0.10, P = 0.004) in the synthetics group than in the autografts group. This systematic review comparing long‐term outcomes after cruciate ligament reconstruction with either autograft or synthetics suggests no significant differences in failure risk. Autografts were inferior to synthetics with respect to restoring knee joint stability and patient‐reported outcome scores, and were also associated with more postoperative complications.
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Affiliation(s)
- Jian Sun
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Xiao-Chun Wei
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Lu Li
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Xiao-Ming Cao
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Kai Li
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Li Guo
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Jian-Gong Lu
- The Institute of Stem Cell and Regenerative Medicine, School of Medicine, Xiamen University, Xiamen, China
| | - Zhi-Qing Duan
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Chuan Xiang
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University; Shanxi Key Lab of Bone and Soft Tissue Injury Repair, Taiyuan, China
| | - Lei Wei
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, Rhode Island, USA
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Lian J, Lian J, Zhong M, Zhu W. Comment on: Posterior cruciate ligament reconstruction for chronic lesions: clinical experience with hamstring versus ligament advanced reinforcement system as graft. INTERNATIONAL ORTHOPAEDICS 2020; 44:1011-1012. [PMID: 32114656 DOI: 10.1007/s00264-020-04514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Jiangen Lian
- Department of Orthopaedic Surgery, Dabu People's Hospital, Dabu, 514200, Guangdong Province, China
| | - Junfeng Lian
- Department of Orthopaedic Surgery, Dabu People's Hospital, Dabu, 514200, Guangdong Province, China
| | - Mingjin Zhong
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China.
| | - Weimin Zhu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China
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Chiang LY, Lee CH, Tong KM, Wang SP, Lee KT, Tsai WC, Chen CP. Posterior cruciate ligament reconstruction implemented by the Ligament Advanced Reinforcement System over a minimum follow-up of 10 years. Knee 2020; 27:165-172. [PMID: 31813699 DOI: 10.1016/j.knee.2019.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 09/08/2019] [Accepted: 11/10/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE This study evaluated the long-term clinical follow-up results of patients who underwent double-bundle posterior cruciate ligament (PCL) reconstruction using the Ligament Advanced Reinforcement System (LARS). METHODS Patients were assessed using clinical scores that included the Tegner activity level scale, the Lysholm score, and the International Knee Documentation Committee (IKDC) score. KT-1000 was adopted to assess stability. Radiographs and magnetic resonance imaging (MRI) were used to evaluate osteoarthritis and LARS condition. RESULTS This study examined 38 patients, of which follow-up procedures were completed for 33 patients, resulting in a follow-up rate of 86.8%. The average follow-up period was 11.9 ± 1.2 years (range: 10.3-14.2 years). The median scores of the clinical scales were as follows: Tegner activity score, 6 (range: five to seven); Lysholm score, 90 (range: 67-100); and IKDC score, 89.7 (range: 46-100). The median of the side-to-side difference (SSD) was four millimeters (range: 0-10 mm). In radiographs, the moderate OA rate was 6.9%. MRI results revealed that 26 patients exhibited ingrowth and 11 patients exhibited partial rupture of the LARS. With SSD ≤ 3 mm set as the standard for successful knee stabilization, the optimal cutoff point of LARS midsubstance thickness in the receiver operating characteristic (ROC) curve analysis was 14.3 mm. CONCLUSIONS Long-term follow-up of the studied patients demonstrated the durability of LARS. However, clinical outcomes showed no enhancement using LARS, so it is not recommended for routine use in PCL reconstruction. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Liang-Yu Chiang
- Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Section 4, Taichung City 40705, Taiwan, ROC; Department of Orthopaedic Surgery, Taichung Armed Forces General Hospital, No.348, Sec.2, Chungshan Rd., Taiping Dist., Taichung City 41152, Taiwan, ROC; School of Medicine, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City 11490, Taiwan, ROC
| | - Cheng-Hung Lee
- Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Section 4, Taichung City 40705, Taiwan, ROC; Department of Biotechnology, HungKuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung City 43302, Taiwan, ROC
| | - Kwok-Man Tong
- Department of Orthopedics, Asia University Hospital, No.222, Fuxin Rd., Wufeng Dist., Taichung City 413, Taiwan, ROC
| | - Shun-Ping Wang
- Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Section 4, Taichung City 40705, Taiwan, ROC
| | - Kun-Tsan Lee
- Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Section 4, Taichung City 40705, Taiwan, ROC
| | - Wen-Chen Tsai
- Department of Public Health, China Medical University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan, ROC
| | - Chao-Ping Chen
- Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Section 4, Taichung City 40705, Taiwan, ROC; Department of Public Health, China Medical University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan, ROC; Jen-Teh Junior College of Medicine, Nursing and Management, No.79-9, Shalunhu, Houlong Township, Miaoli County 356, Taiwan, ROC.
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Saragaglia D, Francony F, Gaillot J, Pailhé R, Rubens-Duval B, Lateur G. Posterior cruciate ligament reconstruction for chronic lesions: clinical experience with hamstring versus ligament advanced reinforcement system as graft. INTERNATIONAL ORTHOPAEDICS 2019; 44:179-185. [DOI: 10.1007/s00264-019-04434-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 10/02/2019] [Indexed: 01/16/2023]
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Hopper GP, Heusdens CH, Dossche L, Mackay GM. Posterior Cruciate Ligament Repair With Suture Tape Augmentation. Arthrosc Tech 2018; 8:e7-e10. [PMID: 30899644 PMCID: PMC6408582 DOI: 10.1016/j.eats.2018.08.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/10/2018] [Indexed: 02/03/2023] Open
Abstract
The posterior cruciate ligament (PCL) acts as the primary restraint to posterior tibial translation of the knee. Injuries to the PCL are rare in isolation and more often are associated with multiligament injuries to the knee. Several PCL reconstruction and PCL repair techniques have been described in the literature, but no single technique has been shown to be the most superior. Internal bracing with suture tape augmentation encourages natural healing and allows early mobilization. This article describes, with video illustration, PCL repair with suture tape augmentation.
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Affiliation(s)
- Graeme P. Hopper
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, Scotland,Address correspondence to Graeme P. Hopper, M.B.Ch.B., M.Sc., M.R.C.S., Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, 120 University Place, Glasgow, Scotland, G12 8TA.
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Ranger P, Senay A, Gratton GR, Lacelle M, Delisle J. LARS synthetic ligaments for the acute management of 111 acute knee dislocations: effective surgical treatment for most ligaments. Knee Surg Sports Traumatol Arthrosc 2018; 26:3673-3681. [PMID: 29691616 DOI: 10.1007/s00167-018-4940-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/04/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE The purpose of this study was to describe the longitudinal outcomes of acute repair and augmentation for the reconstruction of dislocated knees, using LARS synthetic ligaments. METHODS Patients with a knee dislocation surgically treated using LARS synthetic ligament augmentation, with a minimum follow-up of 24 months, were enrolled between 1996 and 2014. Range of motion, Lachman, pivot shift, posterior drawer, step off sign, valgus, varus, KT-1000 arthrometer, Telos technique, IKDC, Lysholm, Tegner, and Meyers scores were obtained every 2 years up to 10 years. RESULTS Median age was 32.1 years (IQR 23.2-43.3) at time of surgery. Median time from trauma to surgery was 9 days and mean follow-up time was 6.6 years. Median questionnaire scores were: Lysholm 79.5 (IQR 65.0-89.0), Tegner 4.0 (IQR 3.7-6.0), Meyers 3.0 (IQR 3.0-4.0), and mean IKDC was 63.8 (SD 18.9). Median flexion and extension of the injured knee was 124° (IQR 115-129.5) and 0° (IQR - 5 to 0), respectively. Median KT-1000 differential was 0.7 mm (IQR 0.1-3.1) for ACL and 0.9 mm (IQR 0.2-1.4) for PCL. Mean differential for Telos was 2.5 mm (SD 5.8) for ACL, 4 mm (IQR 2-6.3) for PCL 30°, and 8.2 mm (SD 4.4) for PCL 90° (consistent with PCL laxity). More than 90% of patients had good anterior articular stability and > 60% of patients had good posterior articular stability. CONCLUSIONS Acute repair and augmentation of knee dislocations with LARS synthetic ligaments resulted in satisfactory outcomes for the ACL and collateral structures. Telos stress radiography showed PCL laxity in more than half of cases despite low laxity results with KT-1000. The perception of patients about knee function was sustained in time. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Pierre Ranger
- Orthopaedic Research Center, Hôpital du Sacré-Coeur de Montréal, 5400, boulevard Gouin Ouest, Montreal, QC, H4J 1C5, Canada
- Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, H2E 1S6, Canada
- Université de Montréal, 2900 bl. Edouard-Montpetit, Montreal, H3T 1J4, Canada
| | - Andréa Senay
- Orthopaedic Research Center, Hôpital du Sacré-Coeur de Montréal, 5400, boulevard Gouin Ouest, Montreal, QC, H4J 1C5, Canada
- Université de Montréal, 2900 bl. Edouard-Montpetit, Montreal, H3T 1J4, Canada
| | | | - Marc Lacelle
- Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, H2E 1S6, Canada
| | - Josée Delisle
- Orthopaedic Research Center, Hôpital du Sacré-Coeur de Montréal, 5400, boulevard Gouin Ouest, Montreal, QC, H4J 1C5, Canada.
- Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, H2E 1S6, Canada.
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Gliatis J, Anagnostou K, Tsoumpos P, Billis E, Papandreou M, Plessas S. Complex knee injuries treated in acute phase: Long-term results using Ligament Augmentation and Reconstruction System artificial ligament. World J Orthop 2018; 9:24-34. [PMID: 29564211 PMCID: PMC5859197 DOI: 10.5312/wjo.v9.i3.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 12/21/2017] [Accepted: 02/05/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System (LARS) artificial ligament to reconstruct posterior cruciate ligament (PCL).
METHODS From September 1997 to June 2010, thirty-eight complex knee injuries were treated, where early arthroscopic PCL reconstructions were undergone, using the LARS (Surgical Implants and Devices, Arc-sur-Tille, France) artificial ligament. Exclusion criteria were: Late (> 4 wk) reconstruction, open technique, isolated PCL reconstruction, knee degenerative disease, combined fracture or vascular injury and use of allograft or autograft for PCL reconstruction. Clinical and functional outcomes were assessed with IKDC Subjective Knee Form, KOS-ADLS questionnaire, Lysholm scale and SF-12 Health Survey. Posterior displacement (PD) was measured with the Telos Stress Device.
RESULTS Seven patients were excluded; two because of co-existing knee osteoarthritis and the remaining five because of failure to attend the final follow-up. The sample consisted of 31 patients with mean age at the time of reconstruction 33.2 ± 12.5 years (range 17-61). The postoperative follow-up was on average 9.27 ± 4.27 years (range 5-18). The mean average IKDC and KOS scores were 79.32 ± 17.1 and 88.1 ± 12.47% respectively. Average PD was 3.61 ± 2.15 mm compared to 0.91 ± 1.17 mm in the uninjured knees (one with grade 1 + and two with grade 2 +). Dial test was found positive in one patient, whereas the quadriceps active drawer test was positive in three patients. None was tested positive on the reverse-pivot shift test. The range of motion (ROM) was normal in thirty knees, in comparison with the contralateral one. There was no extension deficit. Osteoarthritic changes were found in three knees (9.6%).
CONCLUSION Early treatment of complex knee injuries, using LARS artificial ligament for PCL reconstruction sufficiently reduces posterior tibia displacement and provides satisfactory long-term functional outcomes.
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Affiliation(s)
- John Gliatis
- Department of Orthopaedic, University Hospital of Patras, Patras 25100, Greece
| | | | - Pantelis Tsoumpos
- Department of Orthopaedic, University Hospital of Patras, Patras 25100, Greece
| | - Evdokia Billis
- Department of Physical Therapy, Technological Educational Institute of Western Greece, Aigion 25100, Greece
| | - Maria Papandreou
- Department of Physiotherapy, Technological Educational Institute of Athens, Aigion 25100, Greece
| | - Spyridon Plessas
- Department of Orthopaedic, General Hospital of Nikaia “Snt.Panteleimon”, Piraeus 26504, Greece
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Locke RC, Abraham AC, Killian ML. Orthopedic Interface Repair Strategies Based on Native Structural and Mechanical Features of the Multiscale Enthesis. ACS Biomater Sci Eng 2016; 3:2633-2643. [PMID: 32832593 DOI: 10.1021/acsbiomaterials.6b00599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The enthesis is an organ that connects a soft, aligned tissue (tendon/ligament) to a hard, amorphous tissue (bone) via a fibrocartilage interface. Mechanically, the enthesis sustains a dynamic loading environment that includes tensile, compressive, and shear forces. The structural components of the enthesis act to minimize stress concentrations and control stretch at the interface. Current surgical repair of the enthesis, such as in rotator cuff repair and anterior cruciate ligament reconstruction, aim to bridge the gap between the injured ends via reattachment of soft-to-hard tissues or graft replacement. In this review, we discuss the multiscale, morphological, and mechanical characteristics of the fibrocartilage attachment. Additionally, we review historical and recent clinical approaches to treating enthesis injury. Lastly, we explore new technological advancements in tissue-engineered biomaterials that have shown promise in preclinical studies.
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Affiliation(s)
- Ryan C Locke
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware 19716, United States
| | - Adam C Abraham
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York 10032, United States
| | - Megan L Killian
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware 19716, United States
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Wang CH, Guo ZS, Pang F, Zhang LY, Yan M, Yan JH, Li KW, Li XJ, Li Y, Bi L, Han YS. Effects of graphene modification on the bioactivation of polyethylene-terephthalate-based artificial ligaments. ACS APPLIED MATERIALS & INTERFACES 2015; 7:15263-15276. [PMID: 26111253 DOI: 10.1021/acsami.5b02893] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of this study was to investigate whether surface coating with graphene could enhance the surface bioactivation of PET-based artificial ligaments to accelerate graft-to-bone healing after anterior cruciate ligament reconstruction. In an in vitro study, the proliferation of MC3T3-E1 cells and their differentiation on the scaffolds were quantified via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and real-time polymerase chain reaction assays. The significantly higher optical-density values and transcription levels of osteoblast-specific genes indicated that graphene modification could promote the proliferation of MC3T3-E1 cells and accelerate their specific differentiation into osteogenic lineages on scaffolds. In an in vivo test, rabbits were used to establish an extra-articular graft-to-bone healing model. At 4, 8, and 12 weeks after surgery, biomechanical tests, microcomputed tomography analysis, and histological observations were performed. The final results demonstrated that the microstructural parameters, the average mineral apposition rate of the bone, and the biomechanical properties of the graphene-coated polyethylene terephthalate (PET)-based artificial ligament (G-PET-AL) group were significantly higher than those of the PET-AL graft group (P < 0.05). The results of Van Gieson staining indicated that in the G-PET-AL group, there was more newly formed bone than there was in the group in which nongraphene-coated PET-ALs were used. In conclusion, graphene exhibits considerable potential for enhancing the surface bioactivation of materials.
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Affiliation(s)
- Chun-Hui Wang
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Zhong-Shang Guo
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Fei Pang
- ‡Department of Physics, Renmin University of China, No. 59 Zhongguancun Street, Beijing 100872, China
| | - Li-Yuan Zhang
- ‡Department of Physics, Renmin University of China, No. 59 Zhongguancun Street, Beijing 100872, China
| | - Ming Yan
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Jin-Hong Yan
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Ke-Wen Li
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Xiao-Jie Li
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Yong Li
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Long Bi
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
| | - Yi-Sheng Han
- †Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 15 West Change Road, Xi'an 710032, China
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Lubowitz JH. Editorial commentary: synthetic ACL grafts are more important than clinical nonbelievers may realize. Arthroscopy 2015; 31:969-70. [PMID: 25953226 DOI: 10.1016/j.arthro.2015.02.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/25/2015] [Indexed: 02/02/2023]
Abstract
Artificial ACL grafts are structural ties, designed to resist tension, but not designed to undergo biologic ligamentization by the host. Strategically, an artificial ACL graft may be used as reinforcement to augment ACL repair, ACL autograft, ACL allograft, or tissue-engineered ACL. Most artificial ACL grafts have had poor reported outcomes. However, the Ligament Augmentation and Reconstruction System (LARS) artificial ACL graft shows positive clinical outcomes.
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Chen T, Jiang J, Chen S. Status and headway of the clinical application of artificial ligaments. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2015; 2:15-26. [PMID: 29264235 PMCID: PMC5730644 DOI: 10.1016/j.asmart.2014.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/02/2014] [Accepted: 11/24/2014] [Indexed: 12/20/2022]
Abstract
The authors first reviewed the history of clinical application of artificial ligaments. Then, the status of clinical application of artificial ligaments was detailed. Some artificial ligaments possessed comparable efficacy to, and fewer postoperative complications than, allografts and autografts in ligament reconstruction, especially for the anterior cruciate ligament. At the end, the authors focused on the development of two types of artificial ligaments: polyethylene glycol terephthalate artificial ligaments and tissue-engineered ligaments. In conclusion, owing to the advancements in surgical techniques, materials processing, and weaving methods, clinical application of some artificial ligaments so far has demonstrated good outcomes and will become a trend in the future.
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Affiliation(s)
- Tianwu Chen
- Fudan University Sports Medicine Centre, Shanghai, China.,Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Shanghai, China
| | - Jia Jiang
- Fudan University Sports Medicine Centre, Shanghai, China.,Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Shanghai, China
| | - Shiyi Chen
- Fudan University Sports Medicine Centre, Shanghai, China.,Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Shanghai, China
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Kalaci A, Uruc V, Özden R, Gökhan Duman I, Dogramaci Y, Karapinar S, Yaldiz M. The Biocompatibility of Nitinol in Knee Joint Spaces and Femoral Tunnels: An Experimental Study in Rats. J HARD TISSUE BIOL 2014. [DOI: 10.2485/jhtb.23.317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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