Effect of Implanting a Soft Tissue Autograft in a Central-Third Patellar Tendon Defect: Biomechanical and Histological Comparisons

Author:

Kinneberg Kirsten R. C.1,Galloway Marc T.2,Butler David L.,Shearn Jason T.3

Affiliation:

1. University of Cincinnati, School of Energy, Environmental, Biological and Medical Engineering, Biomedical Engineering Program, 2901 Woodside Drive, 601 Engineering Research Center, Cincinnati, OH 45220

2. Cincinnati SportsMedicine & Orthopaedic Center, 7423 Mason-Montgomery Rd., Mason, OH 45040-8082

3. University of Cincinnati, School of Energy, Environmental, Biological and Medical Engineering, Biomedical Engineering Program, 2901 Woodside Drive, 601 Engineering Research Center, ML0048, Cincinnati, OH 45220

Abstract

Previous studies by our laboratory have demonstrated that implanting a stiffer tissue engineered construct at surgery is positively correlated with repair tissue stiffness at 12 weeks. The objective of this study was to test this correlation by implanting a construct that matches normal tissue biomechanical properties. To do this, we utilized a soft tissue patellar tendon autograft to repair a central-third patellar tendon defect. Patellar tendon autograft repairs were contrasted against an unfilled defect repaired by natural healing (NH). We hypothesized that after 12 weeks, patellar tendon autograft repairs would have biomechanical properties superior to NH. Bilateral defects were established in the central-third patellar tendon of skeletally mature (one year old), female New Zealand White rabbits (n = 10). In one limb, the excised tissue, the patellar tendon autograft, was sutured into the defect site. In the contralateral limb, the defect was left empty (natural healing). After 12 weeks of recovery, the animals were euthanized and their limbs were dedicated to biomechanical (n = 7) or histological (n = 3) evaluations. Only stiffness was improved by treatment with patellar tendon autograft relative to natural healing (p = 0.009). Additionally, neither the patellar tendon autograft nor natural healing repairs regenerated a normal zonal insertion site between the tendon and bone. Immunohistochemical staining for collagen type II demonstrated that fibrocartilage-like tissue was regenerated at the tendon-bone interface for both repairs. However, the tissue was disorganized. Insufficient tissue integration at the tendon-to-bone junction led to repair tissue failure at the insertion site during testing. It is important to re-establish the tendon-to-bone insertion site because it provides joint stability and enables force transmission from muscle to tendon and subsequent loading of the tendon. Without loading, tendon mechanical properties deteriorate. Future studies by our laboratory will investigate potential strategies to improve patellar tendon autograft integration into bone using this model.

Publisher

ASME International

Subject

Physiology (medical),Biomedical Engineering

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