The myotendinous junction (MTJ) is a specialized structure in the musculotendinous system, where force is transmitted from muscle to tendon. Animal models have shown that the MTJ takes form of tendon finger-like processes merging with muscle tissue. The human MTJ is largely unknown and has never been described in three dimensions (3D). The aim of this study was to describe the ultrastructure of...

BACKGROUND Long-term studies of posterior cruciate ligament (PCL) reconstruction suggest that normal stability is not restored in the majority of patients. The Achilles tendon allograft is frequently utilized, although recently, the quadriceps tendon has been introduced as an alternative option due to its size and high patellar bone density. PURPOSE/HYPOTHESIS The purpose of this study was to...

BACKGROUND Bone-patellar tendon-bone (bone-tendon-bone) and four-strand hamstring tendon grafts (hamstring) are the most commonly utilized autografts for primary anterior cruciate ligament (ACL) reconstruction. Existing clinical trials, registry studies, and meta-analyses offer conflicting opinions regarding the most favorable graft choice. QUESTIONS/PURPOSES Which graft type for ACL reconstr...

A composite biodegradable polymeric model was developed to enhance tendon graft healing. This model included a biodegradable polylactide (PLA) bolt as the bone anchor and a poly(D,L-lactide-co-glycolide) (PLGA) nanofibrous membrane embedded with collagen as a biomimic patch to promote tendon-bone interface integration. Degradation rate and compressive strength of the PLA bolt were measured afte...

BACKGROUND Harvested hamstring tendon length has received scant attention in published anterior cruciate ligament (ACL) reconstruction literature, yet length can limit the ability to increase graft diameter by folding the tendon over more than once. Indeed, some ultrashort tendons may be too short to yield a clinically useful graft after being folded over just once. Ultimately, the total length...

Arthroscopically assisted anterior cruciate ligament (ACL) reconstruction has been performed at Rush Medical Center since January 1986. Since then, over 3000 arthroscopically assisted ACL reconstructions have been performed at this institution by the 2 senior authors. The surgical procedure has evolved from a 2-incision technique to a single-incision technique. The graft of choice has been auto...

The objective of this study was to investigate whether intermittent administration of parathyroid hormone [1-34] (PTH[1-34]) promotes tendon-bone healing after anterior cruciate ligament (ACL) reconstruction in vivo. A rat model of ACL reconstruction with autograft was established at the left hind leg. Every day, injections of 60 μg PTH[1-34]/kg subcutaneously were given to the PTH group rats (...

Spontaneous Achilles tendon rupture poses a reconstruction problem of great clinical interest because this is the third most common tendon tear 1, and its correction involves the orthopedic surgeon. It occurs mainly in men with a sedentary lifestyle and generally aged between 40 and 50 years, though it can also occur in individuals who exercise regularly and in top-level athletes.Various mechan...

We report a case of staged flexor tendon reconstruction using a silicon Hunter tendon rod implant. This implant is placed during the first stage of the two-stage procedure to facilitate formation of a pseudotendon sheath. The implant is removed and the tendon graft placed during the second stage of the procedure. Radiography after the first stage of the procedure assesses healing of concomitant...

Complications of patellar-tendon allograft for anterior cruciate ligament (ACL) reconstruction in ACL-deficient patients have focused on disease transmission, strength, survivorship, technique, and processing to decrease antigenicity. Little has been described in regard to intrinsic complications of patellar-tendon allograft. This article discusses our experience with a damaged patellar-tendon ...