Does fibrin clot really enhance graft healing after double-bundle ACL reconstruction in a caprine model?

Verfasser / Beitragende:
[Daniel Hensler, Kenneth Illingworth, Volker Musahl, Zachary Working, Tetsuo Kobayashi, Motoko Miyawaki, Stephan Lorenz, Michelle Witt, James Irrgang, Johnny Huard, Freddie Fu]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/3(2015-03-01), 669-679
Format:
Artikel (online)
ID: 605457956
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024 7 0 |a 10.1007/s00167-014-3380-z  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-3380-z 
245 0 0 |a Does fibrin clot really enhance graft healing after double-bundle ACL reconstruction in a caprine model?  |h [Elektronische Daten]  |c [Daniel Hensler, Kenneth Illingworth, Volker Musahl, Zachary Working, Tetsuo Kobayashi, Motoko Miyawaki, Stephan Lorenz, Michelle Witt, James Irrgang, Johnny Huard, Freddie Fu] 
520 3 |a Purpose: Graft healing following anterior cruciate ligament (ACL) reconstruction is a complex process characterized by phases of healing that lead to ACL remodelling. Our hypothesis is that fibrin clot addition to ACL reconstruction will result in advanced graft remodelling and healing when compared to a control group at 12weeks as observed by histology, immunohistochemistry and magnetic resonance imaging (MRI). Methods: Eleven Spanish Boar goats underwent double-bundle ACL reconstruction: 8 were analysed and 3 were excluded. Group 1 was treated with DB ACL reconstruction utilizing autologous fibrin clots (n=4), and group 2 was treated with standard DB ACL-R (n=4). Histological and radiographic analysis was performed at 12weeks. Each animal underwent 3-T MRI immediately after euthanization for evaluation of graft signal intensity utilizing the signal noise quotient (SNQ). Specimens were then sectioned and stored for standard histological and immunohistochemistry testing. Results: The mean ligament tissue maturity index score was significantly higher for group 1 (15±2.3) compared with group 2 (7.7±5.2) (p<0.05). The mean vascularity (cell/mm2) for group 1 was 7.1±1.3 and 9.3±3.1 for group 2 (n.s.). The mean collagen type 1 (% 50×field) for group 1 was 35.8±22.1 and 19.9±20.5 for group 2 (n.s.). The mean SNQ for the AM bundle was 1.1±0.7 for group 1 and 3.1±1.8 for group 2 (n.s.). The mean SNQ for the total PL bundle was significantly lower for group 1 (1.1±0.7) compared with group 2 (3.7±1.3) (p<0.05). There was a significant correlation between the vascularity and the ligament tissue maturity index score as well as between collagen type 1 and SNQ, both AM and PL bundles (p<0.05). Conclusion: The use of fibrin clot in ACL reconstruction in a caprine model demonstrated improved healing with respect to histological analysis of the intra-articular ACL reconstruction segment and decreased signal intensity on MRI. It may lead to improved graft healing and maturation. By accelerating the intra-articular healing and ligamentization, the outcome of patients after ACL-R can be improved with faster return to sports and daily activity. 
540 |a European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2014 
690 7 |a Anterior cruciate ligament  |2 nationallicence 
690 7 |a Fibrin clot  |2 nationallicence 
690 7 |a ACL graft healing  |2 nationallicence 
690 7 |a Double-bundle reconstruction  |2 nationallicence 
690 7 |a Graft remodelling  |2 nationallicence 
700 1 |a Hensler  |D Daniel  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Illingworth  |D Kenneth  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Musahl  |D Volker  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Working  |D Zachary  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Kobayashi  |D Tetsuo  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Miyawaki  |D Motoko  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Lorenz  |D Stephan  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Witt  |D Michelle  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Irrgang  |D James  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Huard  |D Johnny  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
700 1 |a Fu  |D Freddie  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/3(2015-03-01), 669-679  |x 0942-2056  |q 23:3<669  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-3380-z  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-3380-z  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hensler  |D Daniel  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Illingworth  |D Kenneth  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Musahl  |D Volker  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Working  |D Zachary  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kobayashi  |D Tetsuo  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Miyawaki  |D Motoko  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lorenz  |D Stephan  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Witt  |D Michelle  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Irrgang  |D James  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Huard  |D Johnny  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Fu  |D Freddie  |u Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/3(2015-03-01), 669-679  |x 0942-2056  |q 23:3<669  |1 2015  |2 23  |o 167