The Journal of Bone and Joint Surgery (American). 2005;87:2401-2410.
doi:10.2106/JBJS.D.01952
© 2005 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Demirag, B.
Right arrow Articles by Ozturk, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Demirag, B.
Right arrow Articles by Ozturk, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?

Enhancement of Tendon-Bone Healing of Anterior Cruciate Ligament Grafts by Blockage of Matrix Metalloproteinases

Burak Demirag, MD1, Bartu Sarisozen, MD1, Ozgur Ozer, MD1, Tolga Kaplan, MD1 and Cagatay Ozturk, MD1

1 Department of Orthopaedic Surgery, Uludag University Medical School, 16059, Görükle, Bursa, Turkey. E-mail address for B. Demirag: burakdemirag{at}hotmail.com

Investigation performed at the Department of Orthopaedic Surgery, Uludag University Medical School, Bursa, Turkey

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The use of soft-tissue grafts for anterior cruciate ligament reconstruction delays the healing process. This delay may be due to biochemical and/or biomechanical insults. We hypothesized that the blocking effect of {alpha}2-macroglobulin on synovial matrix metalloproteinase activity may enhance the healing of tendon graft in a bone tunnel.

Methods: The study was performed on twenty-eight healthy, skeletally mature New Zealand White rabbits. Each rabbit underwent bilateral anterior cruciate ligament reconstruction with use of the ipsilateral semitendinosus tendon. Alpha-2-macroglobulin ({alpha}2-macroglobulin) was injected into the knee joint in one limb, and the contralateral limb served as a control. The rabbits were killed two weeks (fourteen rabbits) or five weeks (fourteen rabbits) after the operative procedures. The presence of matrix metalloproteinases in synovial fluid, and the blocking effect of {alpha}2-macroglobulin on them, were determined with enzymatic assays. Healing between the tendon and the bone tunnel was assessed morphologically by determining the presence of fibrovascular tissue and collagen fibers. Healing also was assessed quantitatively by measuring the ultimate load to failure of the reconstructed complex.

Results: There was an increase in matrix metalloproteinases in the control group; in contrast, there was a decrease in the study group (p < 0.05). In the control specimens, the fibrovascular tissue at the bone-tendon interface had developed into dense connective tissue with poor vascularization. In the treated specimens, the bone tunnel had more areas of denser connective-tissue ingrowth. The interface tissue was more mature and contained numerous perpendicular collagen bundles (Sharpey fibers). The ultimate load to failure was significantly greater in the {alpha}2-macroglobulin-treated specimens than in the untreated controls at both two and five weeks.

Conclusions: The present study demonstrated that {alpha}2-macroglobulin blockade of matrix metalloproteinases can enhance bone-tendon healing. This effect of {alpha}2-macroglobulin could occur through its effect solely on collagenase or on a subset of matrix metalloproteinases that are present at the healing interface.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Am J Sports MedHome page
L. V. Gulotta, J. R. Rudzki, D. Kovacevic, C. C. T. Chen, D. Milentijevic, and R. J. Williams III
Chondrocyte Death and Cartilage Degradation After Autologous Osteochondral Transplantation Surgery in a Rabbit Model
Am. J. Sports Med., July 1, 2009; 37(7): 1324 - 1333.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
J. B. Tang, Y. Cao, B. Zhu, K.-Q. Xin, X. T. Wang, and P. Y. Liu
Adeno-Associated Virus-2-Mediated bFGF Gene Transfer to Digital Flexor Tendons Significantly Increases Healing Strength. An in Vivo Study
J. Bone Joint Surg. Am., May 1, 2008; 90(5): 1078 - 1089.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
P. L. Hays, S. Kawamura, X.-H. Deng, E. Dagher, K. Mithoefer, L. Ying, and S. A. Rodeo
The Role of Macrophages in Early Healing of a Tendon Graft in a Bone Tunnel
J. Bone Joint Surg. Am., March 1, 2008; 90(3): 565 - 579.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
M. E. Steiner, M. M. Murray, and S. A. Rodeo
Strategies to Improve Anterior Cruciate Ligament Healing and Graft Placement
Am. J. Sports Med., January 1, 2008; 36(1): 176 - 189.
[Abstract] [Full Text] [PDF]