Tendon-to-bone healing using an injectable calcium phosphate cement combined with bone xenograft/BMP composite |
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Authors: | Pan Weimin Li Dan Wei Yiyong Hu Yunyu Zhou Li |
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Affiliation: | 1. Department of Human Movement Studies, Xi''an Physical Education University, Xi''an City, Shaanxi Province 710068, People''s Republic of China;2. Institute of Orthopaedics and Traumatology, Xijing Hospital, The Fourth Military Medical University, Xi''an City, Shaanxi Province 710032, People''s Republic of China;3. Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, People''s Republic of China |
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Abstract: | Injectable calcium phosphate cement (ICPC) has been applied to enhance the tendon-to-bone healing. However, its slow degradation delays the osteointegration of grafted tendon in bone tunnels. We therefore constructed a synthetic biomaterial of ICPC combined with recombined bone xenograft granules (RBX). In this study, the first stage study demonstrated that the ICPCB contained 3 mg BMPs (ICPCB-3) obtained a porous structure. More importantly, the values of ICPCB-3 were highest in cell proliferation, alkaline phosphatase (ALP) activity, expression of osteogenic genes, and newly ectopic bone-forming area (P < 0.05). Then, ICPCB-3 was used in an anterior cruciate ligament (ACL) reconstruction model. Ninety skeletal mature rabbits underwent bilateral ACL reconstructions and were assigned to 3 groups: control group, ICPC alone group, and ICPCB-3 group. Animals were sacrificed at 6, 12 and 24 weeks. The results showed compared with ICPC, ICPCB-3 composite markedly accelerated tendon-to-bone healing. In addition, little remnants were observed in ICPCB-3 group. Moreover, the maximum loads to failure of ICPCB-3 group was significantly higher than ICPC group at 24 weeks (P < 0.01). We conclude that the ICPCB composite, with a porous structure and better osteointegration effect, has direct clinical instruction to arthroscopic techniques of the ACL reconstruction. |
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Keywords: | Calcium phosphate cement Recombined xenograft bone Anterior cruciate ligament reconstruction Tendon-to-bone healing |
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