Strategies to enhance tendon graft - Bone healing in anterior cruciate ligament reconstruction

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Tendon-bone incorporation of a tendon graft within the bone tunnel is a major concern when using a tendon graft for ligament reconstruction. Successful anterior cruciate ligament (ACL) reconstruction with a tendon graft requires solid healing of the tendon graft in the bone tunnels. Improvement of graft healing to bone is crucial to facilitate early and aggressive rehabilitation and a rapid return to full activity. Healing of a tendon graft in a bone tunnel requires bone ingrowth into the tendon. Indirect Sharpey fiber and direct fibrocartilage fixation of the tendon-bone interface provide different anchorage strength and interface properties. Based on normal ACL structure and the function of the insertion site, the ideal tendon graft would attach broadly to the surface of the bone at the femoral and tibial attachment sites by an intermediate zone of fibrocartilage. Theoretically, interface fibrocartilage formation as the translational structure from ligament to bone is physiological and functional. Our strategies to enhance tendon graft to bone healing, including the use of periosteum and a hydrogel containing periosteal progenitor cell and bone morphogenetic protein-2, are described. For clinical application, satisfactory results for ACL reconstruction can be achieved with the use of a periosteum-enveloped hamstring tendon graft.

Original languageEnglish
Pages (from-to)483-493
Number of pages11
JournalChang Gung Medical Journal
Volume32
Issue number5
Publication statusPublished - Sep 2009
Externally publishedYes

Fingerprint

Anterior Cruciate Ligament Reconstruction
Tendons
Transplants
Bone and Bones
Fibrocartilage
Periosteum
Ligaments
Bone Morphogenetic Protein 2
Anterior Cruciate Ligament
Hydrogel
Thigh
Stem Cells
Rehabilitation

Keywords

  • Anterior cruciate ligament
  • Arthroscopy
  • Tendon graft
  • Tendon-bone healing

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Strategies to enhance tendon graft - Bone healing in anterior cruciate ligament reconstruction. / Chen, Chih Hwa.

In: Chang Gung Medical Journal, Vol. 32, No. 5, 09.2009, p. 483-493.

Research output: Contribution to journalArticle

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