EXPERIMENTAL AND MORPHOLOGICAL ASPECTS OF FAILED TENDON AUTO- AND ALLOGRAFTS AFTER ACL RECONSTRUCTION IN EARLY POSTOPERATIVE PERIOD

Cover Page


Cite item

Abstract

Purpose of the study – search for morphological cause of failure for free tendon auto and allografts after ACL reconstruction of the knee joint in early postoperative period during in vivo experiment. Materials and methods. Experiment included two groups of rabbits, each group consisting of 9 animals. In the first group the authors performed ACL autografting by semitendinous tendon harvested from operated limb. In the second group, ACL allografting was made by foot flexor tendon harvested earlier in rabbits excluded from present or other experiments after pretreatment and sterilization in modified Belyakov’s medium. Results. The major cause for failure of ACL tendon grafts after reconstruction in early postoperative period is the necrosis of intraarticular portion of auto or allograft on the 15th day after the procedure. In case of overexposure of the graft in early period the authors observed rupture along intraarticular portion or - more probable - along the demarcation area (serrated line) rather than graft slipping from bone tunnel with slackening. Intra-tunnel graft portion during first several days after the procedure became surrounded by granulated tissue in contrast to intraarticular portion that remained bare of such support. Conclusion. Comparative experimental and morphological study of two options of ACL reconstruction demonstrated a uniformity of alterations in dynamics with a certain delay in development of compensatory and adaptive processes after allografting. Necrosis (or homogenization) of intraarticular portion of auto or allograft is the cause for potential failure of ACL reconstruction in case of an extremely early and unjustified active rehabilitation.

About the authors

A. V. Rybin

Vreden Russian Research Institute of Traumatology and Orthopedics. 8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Author for correspondence.
Email: bynya@list.ru
Cand. Sci. (Med) Researcher of Scientific Department of Sports Traumatology and Rehabilitation Russian Federation

I. A. Kuznetsov

Vreden Russian Research Institute of Traumatology and Orthopedics. 8, ul. Akad. Baykova, St. Petersburg, 195427, Russia
Mechnikov North Western State Medical University. 41, Kirochnaya ul., St. Petersburg, 191015, Russia

Email: bynya@list.ru

Dr. Sci. (Med) Professor, Head of Scientific Department of Sports Traumatology and Rehabilitation

Professor of Department of Traumatology and Orthopedics

Russian Federation

V. P. Rumakin

Vreden Russian Research Institute of Traumatology and Orthopedics. 8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Email: bynya@list.ru
Cand. Sci. (Med) Head of Patoloanatomic Department Russian Federation

G. I. Netylko

Vreden Russian Research Institute of Traumatology and Orthopedics. 8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Email: bynya@list.ru
Dr. Sci. (Med) Head of Scientific Department of Experimental Morphology Russian Federation

M. P. Lomaya

Vreden Russian Research Institute of Traumatology and Orthopedics. 8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Email: bynya@list.ru
Cand. Sci. (Med) Head Trauma and Orthopedic Department Russian Federation

References

  1. Ахпашев А.А., Загородний Н.В., Щеголева Н.Н., Гнелица Н.Н., Королев А.В. Морфологические аспекты несостоятельности аутотрансплантата передней крестообразной связки. Вестник новых медицинских технологий. 2007;xIV(4):47-49.
  2. Рыбин А.В., Кузнецов И.А., Нетылько Г.И., Румакин В.п., Рыков Ю.А. применение обогащенной тромбоцитами плазмы для стимуляции биопластических процессов после артроскопической реконструкции передней крестообразной связки коленного сустава (обзор литературы). Травматология и ортопедия России. 2015;2:106-116.
  3. Рыков Ю.А. Сравнительная оценка морфологической эволюции сухожильных и костных аллотрансплантатов, заготовленных разными способами. Травматология и ортопедия России. 2010;(1):172-174.
  4. Савельев В.И., Корнилов Н.В., Иванкин Д.Е., Лин-ник С.А. Аллотрансплантация формалинизированной костной ткани в травматологии и ортопедии. Спб.: МОРСАР АВ; 2001. 207 с.
  5. Серебряк Т.В. Артроскопическая реконструкция передней крестообразной связки с использованием различных сухожильных трансплантатов: дис. канд. мед. наук. Спб.; 2012. 265 с.
  6. Солодов И.А. применение сухожильных аллотрансплантатов, стерилизованных окисью этилена, для восстановления связочного аппарата коленного сустава: дис. канд. мед. наук. Спб.; 2002. 217 с.
  7. Amiel D., Kleiner J.B., Roux R.D. et al. The phenomenon of «ligamentization»: anterior cruciate ligament reconstruction with autogenous patellar tendon. J orthop res. 1986;4:162-172.
  8. Arnoczky S.P. Anatomy of the anterior cruciate ligament. Clin orthop. 1983;172:19-25.
  9. Beynnon B.D., Johnson R.J. Relevant biomechanics. In: Orthopaedic Sports Medicine. Philadelphia, 1994. р. 1113-1133.
  10. Brown C.H., Carson E.W. Revision anterior cruciate ligament surgery. Clin Sports Med. 1999;18:109-171.
  11. Brown C.H. Revision anterior cruciate ligament surgery. isakos.com/data/abstractpresentations/forumI/2015-06-11/0730-SectionID1014/0730-Brown,Jr/ OUTLINE_EVENT_8482_MEMBER_ID_1205.
  12. Сaborn D.M., Selby J.B. Allograft anterior tibialis tendon with bioabsorbable interference screw fixation in anterior cruciate ligament reconstruction. Arthroscopy. 2002;18(1):102-105.
  13. Claes S., Verdonk P., forsyth R. et al. The «ligamentization» process in anterior cruciate ligament reconstruction: what happens to the human graft? A systematic review of the literature. Am J Sports Med. 2011;39(1):2476-2483. doi: 10.1177/0363546511402662.
  14. Cohen S.B., Sekiya J.K. Allograft safety in anterior cruciate ligament reconstruction. Clin Sports Med. 2007;26(4): 597-605. doi: 10.1016/j.csm.2007.06.003.
  15. Dheerendra S.K., Khan W.S., Singhal R., Shivarathre D.g., Pydisetty R., Johnstone D. Anterior cruciate ligament graft choices: a review of current concepts. open orthop J. 2012;6:281-286. doi: 10.2174/1874325001206010281.
  16. Dong S., Huangfu x., xie g., Zhang y., Shen P., Li x., Qi J., Zhao J. Decellularized versus fresh-frozen allografts in anterior cruciate ligament reconstruction: an in vitro study in a rabbit model. Am J Sports Med. 2015;43(8): 1924-1934. doi: 10.1177/0363546515585314.
  17. Ekdahl M., Wang J.H., Ronga M., fu f.H. graft healing in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2008;16(10):935-947. doi: 10.1007/s00167-008-0584-0.
  18. Frank C.B., Jackson D.W. The science of reconstruction of anterior cruciate ligament. J Bone Joint Surg Am. 1997;79(10):1556-1576.
  19. Fu F.H., Bennett C.H., Ma B., Menetrey J., Lattermann C. Current trends in anterior cruciate ligament reconstruction. Part II. Operative procedures and clinical correlations. Am J Sports Med. 2000;28(1):124-130.
  20. Gillquist J., Odensten M. Arthroscopic reconstruction of the anterior cruciate. Arthroscopy. 1988;4(1):5-9.
  21. Harner C.D., Olson E., Irrgang J.J., Silverstein S., Fu F.H., Silbey M. Allograft versus autograft anterior cruciate ligament reconstruction: 3- to 5-year outcome. Clin orthop. 1996;(324):134-144.
  22. Jackson D.W., Grood E.S., Goldstein J.D. et al. A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model. Am J Sports Med. 1993;21(2):176-185
  23. Janssen R.P., Scheffler S.U. Intra-articular remodeling tendon grafts after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2014;22(9): 2102-2108. doi: 10.1007/s00167-013-2634-5.
  24. Kamath g.V., Redfern J.C., greis P.E., Burks R.T. Revision anterior cruciate ligament reconstruction. Am J Sports Med. 2011;39(1):1999-2017. doi: 10.1177/0363546510370929.
  25. Kraeutler M.J., Bravman J.T., McCarty E.C. Bone-patellar tendon-bone autograft versus allograft in outcomes of anterior cruciate ligament reconstruction: a meta-analysis of 5182 patients. Am J Sports Med. 2013;41(10):2439-2448. doi: 10.1177/0363546513484127.
  26. Krych A.J., Jackson J.D., Hoskin T.L., Dahm D.L. A meta-analysis of patellar tendon autograft versus patellar tendon allograft in anterior cruciate ligament reconstruction. Arthroscopy. 2008;24(3):292-298. doi: 10.1016/j.arthro.2007.08.029.
  27. Laxdal g., Kartus J., Ejerhed L. et al. Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients. Arthroscopy. 2005;21(8):958-964. doi: 10.1016/j.arthro.2005.05.007.
  28. Macaulay A.A., Perfetti D.C., Levine W.N. Anterior cruciate ligament graft choices. Sports Health. 2012;4(1):63-68. doi: 10.1177/1941738111409890.
  29. Magnussen R.A., Lawrence J.T., West R.L., Toth A.P., Taylor D.C., garrett W.E. graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy. 2012;28(4):526-531. doi: 10.1016/j.arthro.2011.11.024.
  30. Mariscalco M.W., flanigan D.C., Mitchell J. et al. The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: A Multicenter Orthopaedic Outcomes Network (MOON) cohort study. Arthroscopy. 2013;29(12):1948-1953. doi: 10.1016/j.arthro.2013.08.025.
  31. Marx R.g. Revision ACL reconstruction. Springer; 2014. 273 р.
  32. Mayr H.O., Stoehr A., Dietrich M. et al. graft-dependent differences in the ligamentization process of anterior cruciate ligament grafts in a sheep trial. Knee Surg Sports Traumatol Arthrosc. 2012;20(5):947-956. doi: 10.1007/s00167-011-1678-7.
  33. Papalia R., franceschi f., Vasta S. et al. Sparing the anterior cruciate ligament remnant: is it worth the hassle? Br Med Bull. 2012;104:91-111. doi: 10.1093/bmb/ldr053
  34. Prodromos C., Joyce B., Shi K. A meta-analysis of stability of autografts compared to allografts after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):851-856.
  35. doi: 10.1007/s00167-007-0328-6.
  36. Scheffler S.U., Schmidt T., gangéy I. et al. fresh-frozen free-tendon allografts versus autografts in anterior cruciate ligament reconstruction: delayed remodeling and inferior mechanical function during long-term healing in sheep. Arthroscopy. 2008;24 (4):448-458. doi: 10.1016/j.arthro.2007.10.011.
  37. Uribe J.W., Hechtman K.S., Zvijac J.E. et al. Revision anterior cruciate ligament surgery: Experiences from Miami. Clin orthop. 1996;(325):91-99.
  38. Vogrin M., Rupreht M., Dinevski D. et al. Effects of a platelet gel on early graft revascularization after anterior cruciate ligament reconstruction: a prospective randomized, double-blind, clinical trial. Eur Surg res. 2010; 45(2):77-85. doi: 10.1159/000318597.
  39. Weiler A., Hoffmann R.f., Bail H.J., Rehm O., Sudkamp N.P. Tendon healing in a bone tunnel: part II. Histologic analysis after biodegradable interference fit fixation in a model of anterior cruciate ligament reconstruction in sheep. Arthroscopy. 2002;18(2):124-135.
  40. Zhang C.L., fan H.B., Xu H., Li Q.H., Guo L. Histological comparison of fate of ligamentous insertion after reconstruction of anterior cruciate ligament: autograft vs allograft. Chin J Traumatol. 2006;9(2):72-76.

Copyright (c) 2016



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies