Effect of vascularized peroneus longus tendon graft reconstruction on anterior cruciate ligament insertion in rabbits_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Pei ¹ ,  LIU Quan ¹ , FAN Zongqing ¹ , WU Min ¹ ,  ZHU Kun ¹ , ZHOU Jiansheng ^1,2 , XIANG Ping ²

1. Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China;
2. Key Laboratory of Tissue and Transplant in Anhui Province, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233000, P.R.China;

Corresponding?author：

LIU Quan, Email: 13955230608@163.com

Keywords：

Anterior cruciate ligament; peroneus longus tendon; ligament reconstruction; blood supply; ligament insertion; rabbit

DOI：

10.7507/1002-1892.201912048

Video：

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Objective To investigate the effect of vascularized peroneus longus tendon graft reconstruction on anterior cruciate ligament (ACL) insertion in rabbits.Methods Eighty healthy New Zealand white rabbits were harvested to prepare ACL injury models and randomly divided into two groups (n=40). The ACL was reconstructed with vascularized peroneus longus tendon graft in group A and peroneus longus tendon graft without blood supply in group B. The survival of animals and the healing of incision were observed after operation; the grafts were taken for gross and histological observations at 4, 8, and 16 weeks; the biomechanical test of the grafts was carried out to record the maximum tensile strength and incidence of ACL insertion rupture at 8 and 16 weeks.Results All animals survived until the experiment completed. General observation showed that the tunnel was combined with grafts, the vascular infiltration was abundant, and no obvious boundary between the tunnel and grafts existed at 16 weeks in group A; there was still an obvious boundary between the tunnel and graft in group B. Histological observation showed that the collagen fibers between tendon and bone in group A increased gradually, the dense fiber connection was formed, and the “tidal-line” like structure similar to the normal ACL insertion was formed at 16 weeks; but the“tidal-line” like structure was not obvious in group B. Biomechanical test showed that there was no significant difference in the incidence of ACL insertion rupture at 8 and 16 weeks between group A and group B (P=0.680; P=0.590), but the maximum tensile strength at 8 and 16 weeks were higher in group A than in group B (t=18.503, P=0.001; t=25.391, P=0.001).Conclusion The vascularized peroneus longus tendon graft for ACL reconstruction can obviously promote the outcome of the ACL insertion.

Citation： ZHANG Pei, LIU Quan, FAN Zongqing, WU Min, ZHU Kun, ZHOU Jiansheng, XIANG Ping. Effect of vascularized peroneus longus tendon graft reconstruction on anterior cruciate ligament insertion in rabbits. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(7): 848-853. doi: 10.7507/1002-1892.201912048 Copy

1.	Kraeutler MJ, Wolsky RM, Vidal AF, et al. Anatomy and biomechanics of the native and reconstructed anterior cruciate ligament: surgical implications. J Bone Joint Surg (Am), 2017, 99(5): 438-445.
2.	Lohmander LS, Englund PM, Dahl LL, et al. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med, 2007, 35(10): 1756-1769.
3.	吳波, 李士光, 趙宗嶠, 等. 保留殘跡前交叉韌帶重建對移植物血供恢復的影響. 中華創傷雜志, 2013, 29(5): 470-473.
4.	周祥興, 黃肖華, 李財云, 等. 帶血管蒂的髕韌帶修復陳舊性前交叉韌帶損傷的臨床療效及其影響因素分析. 創傷外科雜志, 2019, 21(8): 606-611.
5.	張冉, 沙亮. 腱周組織包繞對重建后交叉韌帶移植物組織學及血管內皮因子的影響. 廣西醫科大學學報, 2018, 35(5): 643-647.
6.	黃東紅, 盧啟貴, 李長樹, 等. 關節鏡下自體腘繩肌腱保殘單束重建前交叉韌帶療效分析. 中國矯形外科雜志, 2016, 24(18): 1644-1649.
7.	謝國明, 董士奎, 皇甫小橋, 等. 保留脛骨殘端重建前交叉韌帶對韌帶重塑相關基因表達的影響. 中國修復重建外科雜志, 2016, 30(1): 15-19.
8.	李箭. 膝關節前交叉韌帶損傷修復與重建. 中國修復重建外科雜志, 2019, 33(9): 1057-1059.
9.	Nguyen DT, Ramwadhdoebe TH, van der Hart CP, et al. Intrinsic healing response of the human anterior cruciate ligament: an histological study of reattached ACL remnants. J Orthop Res, 2014, 32(2): 296-301.
10.	Kanamoto T, Tanaka Y, Yonetani Y, et al. Anterior knee symptoms after double-bundle ACL reconstruction with hamstring tendon autografts: an ultrasonographic and power Doppler investigation. Knee Surg Sports Traumatol Arthrosc, 2015, 23(11): 3324-3329.
11.	郝建學, 王明昊, 任康, 等. 不同移植物對兔前叉韌帶重建術后血運變化的影響. 現代生物醫學進展, 2015, 15(36): 7037-7039.
12.	陳天午, 陳世益. 人工韌帶用于前交叉韌帶修復重建: 目前產品與經驗. 中國修復重建外科雜志, 2020, 34(1): 1-9.
13.	陳聰, 馬愔花, 張波, 等. 前交叉韌帶重建后再血管化的影響因素. 中國矯形外科雜志, 2016, 24(2): 147-150.
14.	紀慶明, 楊育暉, 陳昊, 等. 富血小板血漿輔助前交叉韌帶重建治療的臨床療效分析. 中國修復重建外科雜志, 2017, 31(4): 410-416.
15.	郝滋辰, 吳浩, 李陽, 等. 大鼠骨髓來源與前交叉韌帶來源MSCs體外生物學特性比較研究. 中國修復重建外科雜志, 2017, 31(4): 473-480.
16.	Ma Y, Murawski CD, Rahnemai-Azar AA, et al. Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc, 2015, 23(3): 661-668.
17.	張培, 劉泉, 吳敏. TGF-β₁、bFGF 對自體腘繩肌腱重建前交叉韌帶腱-骨愈合的影響. 中華全科醫學雜志, 2020, 18(1): 30-33.
18.	Li Q, Zhang Y, Zhan L, et al. Correlation analysis of magnetic resonance imaging-based graft maturity and outcomes after anterior cruciate ligament reconstruction using International Knee Documentation Committee Score. Am J Phys Med Rehabil, 2019, 98(5): 387-391.
19.	吳冰, 丘志河, 李盛, 等. 自體腘繩肌腱移植重建前交叉韌帶后移植物的組織學研究. 中國修復重建外科雜志, 2018, 32(7): 873-879.
20.	Chen L, Wu Y, Lin G, et al. Graft bending angle affects allograft tendon maturity early after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2018, 26(10): 3048-3054.
21.	Hofbauer M, Soldati F, Szomolanyi P, et al. Hamstring tendon autografts do not show complete graft maturity 6 months postoperatively after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2019, 27(1): 130-136.
22.	周鵬, 邵宏斌, 楊勤旭, 等. 前交叉韌帶重建膝關節本體感覺的恢復. 中國矯形外科雜志, 2019, 27(12): 1073-1077.

1. Kraeutler MJ, Wolsky RM, Vidal AF, et al. Anatomy and biomechanics of the native and reconstructed anterior cruciate ligament: surgical implications. J Bone Joint Surg (Am), 2017, 99(5): 438-445.
2. Lohmander LS, Englund PM, Dahl LL, et al. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med, 2007, 35(10): 1756-1769.
3. 吳波, 李士光, 趙宗嶠, 等. 保留殘跡前交叉韌帶重建對移植物血供恢復的影響. 中華創傷雜志, 2013, 29(5): 470-473.
4. 周祥興, 黃肖華, 李財云, 等. 帶血管蒂的髕韌帶修復陳舊性前交叉韌帶損傷的臨床療效及其影響因素分析. 創傷外科雜志, 2019, 21(8): 606-611.
5. 張冉, 沙亮. 腱周組織包繞對重建后交叉韌帶移植物組織學及血管內皮因子的影響. 廣西醫科大學學報, 2018, 35(5): 643-647.
6. 黃東紅, 盧啟貴, 李長樹, 等. 關節鏡下自體腘繩肌腱保殘單束重建前交叉韌帶療效分析. 中國矯形外科雜志, 2016, 24(18): 1644-1649.
7. 謝國明, 董士奎, 皇甫小橋, 等. 保留脛骨殘端重建前交叉韌帶對韌帶重塑相關基因表達的影響. 中國修復重建外科雜志, 2016, 30(1): 15-19.
8. 李箭. 膝關節前交叉韌帶損傷修復與重建. 中國修復重建外科雜志, 2019, 33(9): 1057-1059.
9. Nguyen DT, Ramwadhdoebe TH, van der Hart CP, et al. Intrinsic healing response of the human anterior cruciate ligament: an histological study of reattached ACL remnants. J Orthop Res, 2014, 32(2): 296-301.
10. Kanamoto T, Tanaka Y, Yonetani Y, et al. Anterior knee symptoms after double-bundle ACL reconstruction with hamstring tendon autografts: an ultrasonographic and power Doppler investigation. Knee Surg Sports Traumatol Arthrosc, 2015, 23(11): 3324-3329.
11. 郝建學, 王明昊, 任康, 等. 不同移植物對兔前叉韌帶重建術后血運變化的影響. 現代生物醫學進展, 2015, 15(36): 7037-7039.
12. 陳天午, 陳世益. 人工韌帶用于前交叉韌帶修復重建: 目前產品與經驗. 中國修復重建外科雜志, 2020, 34(1): 1-9.
13. 陳聰, 馬愔花, 張波, 等. 前交叉韌帶重建后再血管化的影響因素. 中國矯形外科雜志, 2016, 24(2): 147-150.
14. 紀慶明, 楊育暉, 陳昊, 等. 富血小板血漿輔助前交叉韌帶重建治療的臨床療效分析. 中國修復重建外科雜志, 2017, 31(4): 410-416.
15. 郝滋辰, 吳浩, 李陽, 等. 大鼠骨髓來源與前交叉韌帶來源MSCs體外生物學特性比較研究. 中國修復重建外科雜志, 2017, 31(4): 473-480.
16. Ma Y, Murawski CD, Rahnemai-Azar AA, et al. Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc, 2015, 23(3): 661-668.
17. 張培, 劉泉, 吳敏. TGF-β₁、bFGF 對自體腘繩肌腱重建前交叉韌帶腱-骨愈合的影響. 中華全科醫學雜志, 2020, 18(1): 30-33.
18. Li Q, Zhang Y, Zhan L, et al. Correlation analysis of magnetic resonance imaging-based graft maturity and outcomes after anterior cruciate ligament reconstruction using International Knee Documentation Committee Score. Am J Phys Med Rehabil, 2019, 98(5): 387-391.
19. 吳冰, 丘志河, 李盛, 等. 自體腘繩肌腱移植重建前交叉韌帶后移植物的組織學研究. 中國修復重建外科雜志, 2018, 32(7): 873-879.
20. Chen L, Wu Y, Lin G, et al. Graft bending angle affects allograft tendon maturity early after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2018, 26(10): 3048-3054.
21. Hofbauer M, Soldati F, Szomolanyi P, et al. Hamstring tendon autografts do not show complete graft maturity 6 months postoperatively after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2019, 27(1): 130-136.
22. 周鵬, 邵宏斌, 楊勤旭, 等. 前交叉韌帶重建膝關節本體感覺的恢復. 中國矯形外科雜志, 2019, 27(12): 1073-1077.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of vascularized peroneus longus tendon graft reconstruction on anterior cruciate ligament insertion in rabbits

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