Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application

Chih-Hwa Chen, 陳 文哲(Wen-Jer Chen), 施 俊雄(Chung-Yeung Yang), 楊 春勇(Chung-Yeung Yang), 劉 士榮(Shih-Rong Liu), 林 博彥(Po-Yen Lin)

Research output: Contribution to journalArticle

Abstract

Fixation and incorporation of a tendon graft within the bone tunnel is a major concern when performing ligament reconstruction. Periosteum consists of multipotent stem cells, and has the potential to form osteogenic and chondrogenic tissues. The hypothesis that periosteum could enhance tendon-bone healing within the bone tunnel was studied in a rabbit model. Histological and biomechanical analyses were performed 4, 8, and 12 weeks after surgery. Serialhistological analysis of the tendon-bone interface showed that an interface fibrous layer formed by periosteum between the tendon and the bone. This layer became progressively intergrated within the tendon and bone surfaces during the healing process. At 4 weeks, the new cancellous bone lined the bone tunnel, which became interdigitated with interfacial fibrous tissue. At 8 weeks, there was progressive mineralization and maturation of the new bone growing into the interfacial fibrous layer. At 12 weeks, progressive collagen fiber-bone anchorage, maturation and organization developed and fibrocartilage formed between the tendon and bone. Biomechanical testing revealed higher maximal pull-out strength in the periostem-enveloped group at all time points, with a statistically significant difference at 8 and 12 weeks. The periosteum-treated limb had a higher interface strength-to-length ratio and significant increase between two groups at 8 weeks and 12 weeks. The histolofical and biomechanical studies demonstrated a superior process and stronger healing strength when periosteum was sutured on the tendon that transplanted within a bone tunnel. We applied this idea on the ACL reconstruction with hamstring tendon graft to enhance tendon-bone healing.
Original languageEnglish
Pages (from-to)69-78
Number of pages10
JournalJournal of Orthopedic Surgery Taiwan
Volume19
Issue number2
Publication statusPublished - 2002

Fingerprint

Ligaments
Transplants
Bone and Bones
Tendons
Periosteum
Research
Hamstring Tendons
Fibrocartilage
Multipotent Stem Cells
Collagen
Extremities
Rabbits

Keywords

  • Tendon-bone healing
  • Periosteum
  • Anterior cruciate ligament
  • Hamstring tendon graft
  • Arthroscopy

Cite this

Chen, C-H., 陳文哲(Wen-Jer C, 施俊雄(Chung-Yeung Y, 楊春勇(Chung-Yeung Y, 劉士榮(Shih-Rong L, & 林博彥(Po-Yen L (2002). Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application. Journal of Orthopedic Surgery Taiwan, 19(2), 69-78.

Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application. / Chen, Chih-Hwa; 陳文哲(Wen-Jer Chen); 施俊雄(Chung-Yeung Yang); 楊春勇(Chung-Yeung Yang); 劉士榮(Shih-Rong Liu); 林博彥(Po-Yen Lin).

In: Journal of Orthopedic Surgery Taiwan, Vol. 19, No. 2, 2002, p. 69-78.

Research output: Contribution to journalArticle

Chen, C-H, 陳文哲(Wen-JerC, 施俊雄(Chung-YeungY, 楊春勇(Chung-YeungY, 劉士榮(Shih-RongL & 林博彥(Po-YenL 2002, 'Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application', Journal of Orthopedic Surgery Taiwan, vol. 19, no. 2, pp. 69-78.
Chen C-H, 陳文哲(Wen-JerC, 施俊雄(Chung-YeungY, 楊春勇(Chung-YeungY, 劉士榮(Shih-RongL, 林博彥(Po-YenL. Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application. Journal of Orthopedic Surgery Taiwan. 2002;19(2):69-78.
Chen, Chih-Hwa ; 陳文哲(Wen-Jer Chen) ; 施俊雄(Chung-Yeung Yang) ; 楊春勇(Chung-Yeung Yang) ; 劉士榮(Shih-Rong Liu) ; 林博彥(Po-Yen Lin). / Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application. In: Journal of Orthopedic Surgery Taiwan. 2002 ; Vol. 19, No. 2. pp. 69-78.
@article{54b6ab2aa63949a4962d22df3b671116,
title = "Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application",
abstract = "Fixation and incorporation of a tendon graft within the bone tunnel is a major concern when performing ligament reconstruction. Periosteum consists of multipotent stem cells, and has the potential to form osteogenic and chondrogenic tissues. The hypothesis that periosteum could enhance tendon-bone healing within the bone tunnel was studied in a rabbit model. Histological and biomechanical analyses were performed 4, 8, and 12 weeks after surgery. Serialhistological analysis of the tendon-bone interface showed that an interface fibrous layer formed by periosteum between the tendon and the bone. This layer became progressively intergrated within the tendon and bone surfaces during the healing process. At 4 weeks, the new cancellous bone lined the bone tunnel, which became interdigitated with interfacial fibrous tissue. At 8 weeks, there was progressive mineralization and maturation of the new bone growing into the interfacial fibrous layer. At 12 weeks, progressive collagen fiber-bone anchorage, maturation and organization developed and fibrocartilage formed between the tendon and bone. Biomechanical testing revealed higher maximal pull-out strength in the periostem-enveloped group at all time points, with a statistically significant difference at 8 and 12 weeks. The periosteum-treated limb had a higher interface strength-to-length ratio and significant increase between two groups at 8 weeks and 12 weeks. The histolofical and biomechanical studies demonstrated a superior process and stronger healing strength when periosteum was sutured on the tendon that transplanted within a bone tunnel. We applied this idea on the ACL reconstruction with hamstring tendon graft to enhance tendon-bone healing.",
keywords = "Tendon-bone healing, Periosteum, Anterior cruciate ligament, Hamstring tendon graft, Arthroscopy",
author = "Chih-Hwa Chen and 陳, {文哲(Wen-Jer Chen)} and 施, {俊雄(Chung-Yeung Yang)} and 楊, {春勇(Chung-Yeung Yang)} and 劉, {士榮(Shih-Rong Liu)} and 林, {博彥(Po-Yen Lin)}",
year = "2002",
language = "English",
volume = "19",
pages = "69--78",
journal = "Journal of Orthopedic Surgery Taiwan",
issn = "1011-6923",
publisher = "中華民國骨科醫學會",
number = "2",

}

TY - JOUR

T1 - Perioteum-Enveloping Hamstring Tendon Graft for Anterior Gruciate Ligament Reconstruction-From Basic Research to Clincal Application

AU - Chen, Chih-Hwa

AU - 陳, 文哲(Wen-Jer Chen)

AU - 施, 俊雄(Chung-Yeung Yang)

AU - 楊, 春勇(Chung-Yeung Yang)

AU - 劉, 士榮(Shih-Rong Liu)

AU - 林, 博彥(Po-Yen Lin)

PY - 2002

Y1 - 2002

N2 - Fixation and incorporation of a tendon graft within the bone tunnel is a major concern when performing ligament reconstruction. Periosteum consists of multipotent stem cells, and has the potential to form osteogenic and chondrogenic tissues. The hypothesis that periosteum could enhance tendon-bone healing within the bone tunnel was studied in a rabbit model. Histological and biomechanical analyses were performed 4, 8, and 12 weeks after surgery. Serialhistological analysis of the tendon-bone interface showed that an interface fibrous layer formed by periosteum between the tendon and the bone. This layer became progressively intergrated within the tendon and bone surfaces during the healing process. At 4 weeks, the new cancellous bone lined the bone tunnel, which became interdigitated with interfacial fibrous tissue. At 8 weeks, there was progressive mineralization and maturation of the new bone growing into the interfacial fibrous layer. At 12 weeks, progressive collagen fiber-bone anchorage, maturation and organization developed and fibrocartilage formed between the tendon and bone. Biomechanical testing revealed higher maximal pull-out strength in the periostem-enveloped group at all time points, with a statistically significant difference at 8 and 12 weeks. The periosteum-treated limb had a higher interface strength-to-length ratio and significant increase between two groups at 8 weeks and 12 weeks. The histolofical and biomechanical studies demonstrated a superior process and stronger healing strength when periosteum was sutured on the tendon that transplanted within a bone tunnel. We applied this idea on the ACL reconstruction with hamstring tendon graft to enhance tendon-bone healing.

AB - Fixation and incorporation of a tendon graft within the bone tunnel is a major concern when performing ligament reconstruction. Periosteum consists of multipotent stem cells, and has the potential to form osteogenic and chondrogenic tissues. The hypothesis that periosteum could enhance tendon-bone healing within the bone tunnel was studied in a rabbit model. Histological and biomechanical analyses were performed 4, 8, and 12 weeks after surgery. Serialhistological analysis of the tendon-bone interface showed that an interface fibrous layer formed by periosteum between the tendon and the bone. This layer became progressively intergrated within the tendon and bone surfaces during the healing process. At 4 weeks, the new cancellous bone lined the bone tunnel, which became interdigitated with interfacial fibrous tissue. At 8 weeks, there was progressive mineralization and maturation of the new bone growing into the interfacial fibrous layer. At 12 weeks, progressive collagen fiber-bone anchorage, maturation and organization developed and fibrocartilage formed between the tendon and bone. Biomechanical testing revealed higher maximal pull-out strength in the periostem-enveloped group at all time points, with a statistically significant difference at 8 and 12 weeks. The periosteum-treated limb had a higher interface strength-to-length ratio and significant increase between two groups at 8 weeks and 12 weeks. The histolofical and biomechanical studies demonstrated a superior process and stronger healing strength when periosteum was sutured on the tendon that transplanted within a bone tunnel. We applied this idea on the ACL reconstruction with hamstring tendon graft to enhance tendon-bone healing.

KW - Tendon-bone healing

KW - Periosteum

KW - Anterior cruciate ligament

KW - Hamstring tendon graft

KW - Arthroscopy

M3 - Article

VL - 19

SP - 69

EP - 78

JO - Journal of Orthopedic Surgery Taiwan

JF - Journal of Orthopedic Surgery Taiwan

SN - 1011-6923

IS - 2

ER -