Bone-to-Bone Fixation Enhances Functional Healing of the Porcine Anterior Cruciate Ligament Using a Collagen-Platelet Composite

Department of Orthopaedic Surgery, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
Arthroscopy The Journal of Arthroscopic and Related Surgery (Impact Factor: 3.21). 09/2010; 26(9 Suppl):S49-57. DOI: 10.1016/j.arthro.2009.12.017
Source: PubMed


The purpose of this study was to determine whether providing bony stabilization between the tibia and femur improves the structural properties of an "enhanced" anterior cruciate ligament (ACL) repair using a collagen-platelet composite when compared with the traditional (Marshall) suture technique.
Twelve pigs underwent unilateral ACL transection and were treated with sutures connecting the bony femoral ACL attachment site to the distal ACL stump (ligament group) or to the tibia through a bone tunnel (tibia group). A collagen-platelet composite was placed around the sutures to enhance the biological repair in both groups. Anteroposterior knee laxity and the graft structural properties were measured after 15 weeks of healing in both the ACL-repaired and contralateral, ACL-intact joints.
Enhanced ACL repair with bone-to-bone fixation significantly improved yield load and linear stiffness of the ACL repairs (P < .05) after 15 weeks of healing. However, laxity values of the knees were similar in both groups of repaired knees (P > .10).
Using an enhanced ACL suture repair technique that includes bone-to-bone fixation to protect the repair in the initial healing stages resulted in an ACL with improved structural properties after 15 weeks in the porcine model.
The healing response of an ACL suture repair by use of a collagen-platelet composite can be enhanced by providing bony stabilization between the tibia and femur to protect the graft during the initial healing process in a translational model.

Download full-text


Available from: David Zurakowski
  • Source
    • "With IACUC approval, 12 adult sheep underwent unilateral ACL transection surgery followed by bio-enhanced ACL repair as previously described (Murray et al., 2010). After 20 weeks of healing, the animals were euthanized and the knees were harvested. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Current MR methods use T2(⁎) relaxation time as a surrogate measure of ligament strength. Currently, a multi-echo voxel-wise least squares fit is the gold standard to create T2(⁎) maps; however, the post-processing is time-intensive and serves as a stopgap for clinical use. The study objective was to determine if an alternative method could improve post-processing time without sacrificing fidelity of T2(⁎) values for eventual translational use in the clinic. Using a 6 echo FLASH sequence, three different methods were used to determine intact posterior cruciate ligament (PCL) median T2(⁎) Two of these methods utilized a voxel-wise method to establish T2(⁎) maps: (1) a current "gold standard" method using a voxel-wise 6 echo least-squares fit (6LS) and (2) a voxel-wise 2 echo point T2(⁎) determination (2MM). The third method used median ligament signal intensity and a single nonlinear least-squares fit (6LSROI) instead of a voxel-wise basis. The resulting median T2(⁎) values of the PCL and computational time were compared. The median T2(⁎) values were 42% higher using the 2MM compared to the 6LS method (p<0.0001). However, a strong correlation was found for the median T2(⁎) values between the 2MM and 6LS methods (R(2)=0.80). The median T2(⁎) values were not significantly different between the 6LS and 6LSROI methods (p=0.519). Using the 2MM (which provides a regional map) and the 6LSROI (which efficiently provides the median T2(⁎) value) methods in tandem would take only minutes of post-processing computational time compared to the 6LS method (~540min), and hence would facilitate clinical application of T2(⁎) maps to predict ligament structural properties as a patient outcome measure.
    Full-text · Article · Apr 2014 · Journal of Biomechanics
  • [Show abstract] [Hide abstract]
    ABSTRACT: Queueing systems arise in different areas of human activity, especially in managing and controlling of production systems. Queues appear in modern communication systems, by maintenance of complicated equipment, and so on. The main problem here is to choose the optimal rate of servicing: on the one hand, the small rate results in the bad work of the system as a whole, on the other hand, the big rate of servicing can occur too expensive. So, the problems of optimal control very often are multicriteria. The most proper mathematical model for investigation of any queueing system is jump stochastic process. Of course, if the investigated system is controlled, the jump process must be controlled too. So, the description of the multicriteria optimization problem is presented for jump stochastic processes. The suggested method for solving the problem is the method of constraints. The main results are based on general theorems of convex analysis. The theoretical results are used for the solving of specific optimization problem for the single-channel queueing system with refusals. The controlling parameter (action) is the service rate, and one should minimize the penalty for refusals and the losses conditioned by the service
    No preview · Conference Paper · Nov 1995
  • [Show abstract] [Hide abstract]
    ABSTRACT: Not Available
    No preview · Conference Paper · Oct 2005
Show more