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.	吴波, 李士光, 赵宗峤, 等. 保留残迹前交叉韧带重建对移植物血供恢复的影响. 中华创伤杂志, 2013, 29(5): 470-473.
4.	周祥兴, 黄肖华, 李财云, 等. 带血管蒂的髌韧带修复陈旧性前交叉韧带损伤的临床疗效及其影响因素分析. 创伤外科杂志, 2019, 21(8): 606-611.
5.	张冉, 沙亮. 腱周组织包绕对重建后交叉韧带移植物组织学及血管内皮因子的影响. 广西医科大学学报, 2018, 35(5): 643-647.
6.	黄东红, 卢启贵, 李长树, 等. 关节镜下自体腘绳肌腱保残单束重建前交叉韧带疗效分析. 中国矫形外科杂志, 2016, 24(18): 1644-1649.
7.	谢国明, 董士奎, 皇甫小桥, 等. 保留胫骨残端重建前交叉韧带对韧带重塑相关基因表达的影响. 中国修复重建外科杂志, 2016, 30(1): 15-19.
8.	李箭. 膝关节前交叉韧带损伤修复与重建. 中国修复重建外科杂志, 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.	郝建学, 王明昊, 任康, 等. 不同移植物对兔前叉韧带重建术后血运变化的影响. 现代生物医学进展, 2015, 15(36): 7037-7039.
12.	陈天午, 陈世益. 人工韧带用于前交叉韧带修复重建: 目前产品与经验. 中国修复重建外科杂志, 2020, 34(1): 1-9.
13.	陈聪, 马愔花, 张波, 等. 前交叉韧带重建后再血管化的影响因素. 中国矫形外科杂志, 2016, 24(2): 147-150.
14.	纪庆明, 杨育晖, 陈昊, 等. 富血小板血浆辅助前交叉韧带重建治疗的临床疗效分析. 中国修复重建外科杂志, 2017, 31(4): 410-416.
15.	郝滋辰, 吴浩, 李阳, 等. 大鼠骨髓来源与前交叉韧带来源MSCs体外生物学特性比较研究. 中国修复重建外科杂志, 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.	张培, 刘泉, 吴敏. TGF-β₁、bFGF 对自体腘绳肌腱重建前交叉韧带腱-骨愈合的影响. 中华全科医学杂志, 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.	吴冰, 丘志河, 李盛, 等. 自体腘绳肌腱移植重建前交叉韧带后移植物的组织学研究. 中国修复重建外科杂志, 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.	周鹏, 邵宏斌, 杨勤旭, 等. 前交叉韧带重建膝关节本体感觉的恢复. 中国矫形外科杂志, 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. 吴波, 李士光, 赵宗峤, 等. 保留残迹前交叉韧带重建对移植物血供恢复的影响. 中华创伤杂志, 2013, 29(5): 470-473.
4. 周祥兴, 黄肖华, 李财云, 等. 带血管蒂的髌韧带修复陈旧性前交叉韧带损伤的临床疗效及其影响因素分析. 创伤外科杂志, 2019, 21(8): 606-611.
5. 张冉, 沙亮. 腱周组织包绕对重建后交叉韧带移植物组织学及血管内皮因子的影响. 广西医科大学学报, 2018, 35(5): 643-647.
6. 黄东红, 卢启贵, 李长树, 等. 关节镜下自体腘绳肌腱保残单束重建前交叉韧带疗效分析. 中国矫形外科杂志, 2016, 24(18): 1644-1649.
7. 谢国明, 董士奎, 皇甫小桥, 等. 保留胫骨残端重建前交叉韧带对韧带重塑相关基因表达的影响. 中国修复重建外科杂志, 2016, 30(1): 15-19.
8. 李箭. 膝关节前交叉韧带损伤修复与重建. 中国修复重建外科杂志, 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. 郝建学, 王明昊, 任康, 等. 不同移植物对兔前叉韧带重建术后血运变化的影响. 现代生物医学进展, 2015, 15(36): 7037-7039.
12. 陈天午, 陈世益. 人工韧带用于前交叉韧带修复重建: 目前产品与经验. 中国修复重建外科杂志, 2020, 34(1): 1-9.
13. 陈聪, 马愔花, 张波, 等. 前交叉韧带重建后再血管化的影响因素. 中国矫形外科杂志, 2016, 24(2): 147-150.
14. 纪庆明, 杨育晖, 陈昊, 等. 富血小板血浆辅助前交叉韧带重建治疗的临床疗效分析. 中国修复重建外科杂志, 2017, 31(4): 410-416.
15. 郝滋辰, 吴浩, 李阳, 等. 大鼠骨髓来源与前交叉韧带来源MSCs体外生物学特性比较研究. 中国修复重建外科杂志, 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. 张培, 刘泉, 吴敏. TGF-β₁、bFGF 对自体腘绳肌腱重建前交叉韧带腱-骨愈合的影响. 中华全科医学杂志, 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. 吴冰, 丘志河, 李盛, 等. 自体腘绳肌腱移植重建前交叉韧带后移植物的组织学研究. 中国修复重建外科杂志, 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. 周鹏, 邵宏斌, 杨勤旭, 等. 前交叉韧带重建膝关节本体感觉的恢复. 中国矫形外科杂志, 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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