Biology and augmentation of tendon-bone insertion repair
نویسندگان
چکیده
Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL) reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis") which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be paid to augment tendon to bone insertion (TBI) healing. Apart from surgical fixation, biological and biophysical interventions have been studied aiming at regeneration of TBI healing complex, especially the regeneration of interpositioned fibrocartilage and new bone at the healing junction. This paper described the biology and the factors influencing TBI healing using patella-patellar tendon (PPT) healing and tendon graft to bone tunnel healing in ACL reconstruction as examples. Recent development in the improvement of TBI healing and directions for future studies were also reviewed and discussed.
منابع مشابه
SYMPOSIUM: NEW APPROACHES TO SHOULDER SURGERY Biological Augmentation of Rotator Cuff Tendon Repair
A histologically normal insertion site does not regenerate following rotator cuff tendon-to-bone repair, which is likely due to abnormal or insufficient gene expression and/or cell differentiation at the repair site. Techniques to manipulate the biologic events following tendon repair may improve healing. We used a sheep infraspinatus repair model to evaluate the effect of osteoinductive growth...
متن کاملInterstitial Tear of the Subscapularis Tendon, Arthroscopic Findings and Technique of Repair
Tears of the subscapularis tendon have been significantly recognized as a source of shoulder pain and dysfunction in the past decade, thanks to arthroscopic evaluation of the shoulder and biomechanical and anatomical studies of the tendon. Current classification of subscapularis tendon tear is based on insertion site of the tendon. Recently, a classification for non-insertional types of subsc...
متن کاملXenograft scaffold full-wrap reinforcement of Krackow achilles tendon repair.
Standard 4-strand repair of Achilles tendon tears is effective, but additional strength may be desirable in patients who are compromised or those with reruptures. Use of a xenograft scaffold has not been investigated biomechanically in Achilles tendon repair. This study compared stiffness, gap formation, and ultimate load to failure with Krackow repair vs Krackow repair augmented with xenograft...
متن کاملUse of Undifferentiated Cultured Bone Marrow-Derived Mesenchymal Stem Cells for DDF Tendon Injuries Repair in Rabbits: A Quantitative and Qualitative Histopathological Study
Objective- To investigate the effect of intratendinous injection of bMSCs on the rate and extent of tendon healing after primary repair in a rabbit model. Design- Experimental study. Animals- Twenty seven skeletally mature New Zealand white rabbits weighing 1.8- 2.5 kg were used. Twenty rabbits were used as the experimental animals, and seven others were used as a source of bone marrow-derived ...
متن کاملDemineralized Bone Matrix to Augment Tendon-Bone Healing: A Systematic Review
Background Following injury to the rotator cuff and anterior cruciate ligament, a direct enthesis is not regenerated, and healing occurs with biomechanically inferior fibrous tissue. Demineralized bone matrix (DBM) is a collagen scaffold that contains growth factors and is a promising biological material for tendon and ligament repair because it can regenerate a direct fibrocartilaginous insert...
متن کامل