Research progress on bioactive strategies for promoting tendon graft healing after anterior cruciate ligament reconstruction / 中国修复重建外科杂志

OBJECTIVE@#To review the bioactive strategies that enhance tendon graft healing after anterior cruciate ligament reconstruction (ACLR), and to provide insights for improving the therapeutic outcomes of ACLR.@*METHODS@#The domestic and foreign literature related to the bioactive strategies for promoting the healing of tendon grafts after ACLR was extensively reviewed and summarized.@*RESULTS@#At present, there are several kinds of bioactive materials related to tendon graft healing after ACLR: growth factors, cells, biodegradable implants/tissue derivatives. By constructing a complex interface simulating the matrix, environment, and regulatory factors required for the growth of native anterior cruciate ligament (ACL), the growth of transplanted tendons is regulated at different levels, thus promoting the healing of tendon grafts. Although the effectiveness of ACLR has been significantly improved in most studies, most of them are still limited to the early stage of animal experiments, and there is still a long way to go from the real clinical promotion. In addition, limited by the current preparation technology, the bionics of the interface still stays at the micron and millimeter level, and tends to be morphological bionics, and the research on the signal mechanism pathway is still insufficient.@*CONCLUSION@#With the further study of ACL anatomy, development, and the improvement of preparation technology, the research of bioactive strategies to promote the healing of tendon grafts after ACLR is expected to be further promoted.

Ligamentization of Autogenous Hamstring Grafts after Anterior Cruciate Ligament Reconstruction / 中国运动医学杂志

Objective To investigate the ligamentization process of autogenous hamstring grafts after anterior cruciate ligament (ACL)reconstruction and explore its potential influencing factors.Methods Patients undergoing the ACL reconstruction between January and December 2014 were recorded demographic data including their gender,age,weight,height,body mass index (BMI),general joint relaxation(the Beighton score),and their surgical duration.Six,12,and 24 months after the operation,the signal intensity of the proximal,middle and distal part of the ACL grafts was measured using MRI,and the signal to noise quotient (SNQ)was calculated to assess the graft maturity.The data were analyzed statistically to explore the ligamentization process of grafts and its potential influencing factors.Results A total of 87 patients receiving ACL reconstruction were enrolled in this study.The results showed that the SNQ of the proximal and middle part of the ACL grafts decreased gradually with time,and significant differences were observed in the SNQ value of the proximal part between 24 months and that of 6 and 12 months(P＜0.05).There was no significant difference in the SNQ value of the distal part at different time points.The SNQ values of grafts were not significantly affected by the gender,age,body weight,height,BMI,Beighton score or ACL duration(P＞0.05).Conclusion The ligamentization of autogenous hamstring grafts after ACL reconstruction increases gradually with timent positive correlation with postoperative time.

Comparison of Magnetic Resonance Imaging of Remnant Preserving versus Remnant Sacrificing Technique after Anterior Cruciate Ligament Reconstruction; Clinical Results and Second-Look Arthroscopic Findings: Pilot Study / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to clarify the difference between the remnant-preserving and remnant-sacrificing techniques in anterior cruciate ligament (ACL) reconstruction using stress test, functional score, 2nd look arthroscopy and magnetic resonance imaging (MRI). MATERIALS AND METHODS: Among 66 patients having anatomical ACL reconstruction with the fourstrand hamstring autograft using outside-in technique (FlipCutter(R)) for the femoral tunnel from April 2012 to April 2014, 23 patients who underwent 2nd look arthroscopy and MRI were included. The remnant-preserving group included 12 patients and the remnant-sacrificing group included 11 patients. The two groups were compared and analyzed with regard to stability (Stress test using GNRB(R), pivot shift test), functional assessment (International Knee Documentation Committee [IKDC] scale, Lysholm score, one leg hoop test), and the result of second-look arthroscopy and signal to noise quotient (SNQ) ratio of the graft in MRI. RESULTS: The two groups did not differ significantly in the stability test, IKDC scale, and Lysholm test. The remnant-preserving group showed significant improvement in one leg hoop test compared with the remnant-sacrificing group (p0.05). CONCLUSION: More than 12 months after surgery, the graft of the remnant-preserving group showed lower signal intensity compared to that of the remnant-sacrificing group by MRI evaluation. The remnant preserving technique has biological difference compared with the remnant sacrificing technique in human study.