Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model
Abstract Background Anterior cruciate ligament (ACL) repair techniques are new emerging strategies prevailing, in selected cases, over standard reconstruction of the ACL with excision of its remnants. Mid-substance ACL tears represent a challenge for ACL repair techniques, and remnants-preserving AC...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02890-9 |
| _version_ | 1817997761107197952 |
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| author | Emeline Maurice Thibault Godineau Diane Pichard Hanane El Hafci Gwennhael Autret Morad Bensidhoum Véronique Migonney Mathieu Manassero Véronique Viateau |
| author_facet | Emeline Maurice Thibault Godineau Diane Pichard Hanane El Hafci Gwennhael Autret Morad Bensidhoum Véronique Migonney Mathieu Manassero Véronique Viateau |
| author_sort | Emeline Maurice |
| collection | DOAJ |
| description | Abstract Background Anterior cruciate ligament (ACL) repair techniques are new emerging strategies prevailing, in selected cases, over standard reconstruction of the ACL with excision of its remnants. Mid-substance ACL tears represent a challenge for ACL repair techniques, and remnants-preserving ACL reconstruction (rp-ACLR) using an autograft remains the recommended treatment in this situation. However, morbidity associated with the autograft harvesting prompts the need for alternative surgical strategies based on the use of synthetic scaffolds. Relevant small animal models of mid-substance tears with ACL remnants preservation and reconstruction are necessary to establish the preliminary proof of concept of these new strategies. Methods A rat model of rp-ACLR using a tendinous autograft after complete mid-substance ACL transection was established. Twelve weeks following surgery, clinical outcomes and knee joints were assessed through visual gait analysis, Lachman tests, thigh perimeter measurements, magnetic resonance imaging, micro-computed tomography, and histology, to evaluate the morbidity of the procedure, accuracy of bone tunnel positioning, ACL remnants fate, osteoarthritis, and autograft bony integration. Results were compared with those obtained with isolated ACL transection without reconstruction and to right non-operated knees. Results and discussion Most operated animals were weight-bearing the day following surgery, and no adverse inflammatory reaction has been observed for the whole duration of the study. Autograft fixation with cortical screws provided effective graft anchorage until sacrifice. Healing of the transected ACL was not observed in the animals in which no graft reconstruction was performed. rp-ACLR was associated with a reduced degeneration of the ACL remnants (p = 0.004) and cartilages (p = 0.0437). Joint effusion and synovitis were significantly lower in the reconstructed group compared to the transected ACL group (p = 0.004). Most of the bone tunnel apertures were anatomically positioned in the coronal and/or sagittal plane. The most deviated bone tunnel apertures were the tibial ones, located in median less than 1 mm posteriorly to anatomical ACL footprint center. Conclusion This study presents a cost-effective, new relevant and objective rat model associated with low morbidity for the preliminary study of bio-implantable materials designed for remnants-preserving ACL surgery after mid-substance ACL tear. |
| first_indexed | 2024-04-14T02:43:06Z |
| format | Article |
| id | doaj.art-1b2269cf640048a68420a6529b7117a2 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T02:43:06Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-1b2269cf640048a68420a6529b7117a22022-12-22T02:16:42ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-01-0117111610.1186/s13018-021-02890-9Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat modelEmeline Maurice0Thibault Godineau1Diane Pichard2Hanane El Hafci3Gwennhael Autret4Morad Bensidhoum5Véronique Migonney6Mathieu Manassero7Véronique Viateau8Unité de Chirurgie, École Nationale Vétérinaire d’Alfort, Université Paris-Est-CréteilUnité de Chirurgie, École Nationale Vétérinaire d’Alfort, Université Paris-Est-CréteilUnité de Chirurgie, École Nationale Vétérinaire d’Alfort, Université Paris-Est-CréteilLaboratoire de Biologie, Bioingénierie et Bioimagerie Ostéo-Articulaires (LB30A), UMR 7052, Université Paris Diderot Paris 7INSERM, PARCC, Université de ParisLaboratoire de Biologie, Bioingénierie et Bioimagerie Ostéo-Articulaires (LB30A), UMR 7052, Université Paris Diderot Paris 7Laboratoire de Biomatériaux et Polymères de Spécialité (LBPS), Laboratoire Chimie, Structures, Propriétés de Biomatériaux et d’Agents Thérapeutiques (CSPBAT), UMR CNRS 7244, Université Sorbonne Paris NordUnité de Chirurgie, École Nationale Vétérinaire d’Alfort, Université Paris-Est-CréteilUnité de Chirurgie, École Nationale Vétérinaire d’Alfort, Université Paris-Est-CréteilAbstract Background Anterior cruciate ligament (ACL) repair techniques are new emerging strategies prevailing, in selected cases, over standard reconstruction of the ACL with excision of its remnants. Mid-substance ACL tears represent a challenge for ACL repair techniques, and remnants-preserving ACL reconstruction (rp-ACLR) using an autograft remains the recommended treatment in this situation. However, morbidity associated with the autograft harvesting prompts the need for alternative surgical strategies based on the use of synthetic scaffolds. Relevant small animal models of mid-substance tears with ACL remnants preservation and reconstruction are necessary to establish the preliminary proof of concept of these new strategies. Methods A rat model of rp-ACLR using a tendinous autograft after complete mid-substance ACL transection was established. Twelve weeks following surgery, clinical outcomes and knee joints were assessed through visual gait analysis, Lachman tests, thigh perimeter measurements, magnetic resonance imaging, micro-computed tomography, and histology, to evaluate the morbidity of the procedure, accuracy of bone tunnel positioning, ACL remnants fate, osteoarthritis, and autograft bony integration. Results were compared with those obtained with isolated ACL transection without reconstruction and to right non-operated knees. Results and discussion Most operated animals were weight-bearing the day following surgery, and no adverse inflammatory reaction has been observed for the whole duration of the study. Autograft fixation with cortical screws provided effective graft anchorage until sacrifice. Healing of the transected ACL was not observed in the animals in which no graft reconstruction was performed. rp-ACLR was associated with a reduced degeneration of the ACL remnants (p = 0.004) and cartilages (p = 0.0437). Joint effusion and synovitis were significantly lower in the reconstructed group compared to the transected ACL group (p = 0.004). Most of the bone tunnel apertures were anatomically positioned in the coronal and/or sagittal plane. The most deviated bone tunnel apertures were the tibial ones, located in median less than 1 mm posteriorly to anatomical ACL footprint center. Conclusion This study presents a cost-effective, new relevant and objective rat model associated with low morbidity for the preliminary study of bio-implantable materials designed for remnants-preserving ACL surgery after mid-substance ACL tear.https://doi.org/10.1186/s13018-021-02890-9Anterior cruciate ligament reconstructionRemnants’ preservationAnimal modelRatTendinous autograftInterference screw |
| spellingShingle | Emeline Maurice Thibault Godineau Diane Pichard Hanane El Hafci Gwennhael Autret Morad Bensidhoum Véronique Migonney Mathieu Manassero Véronique Viateau Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model Journal of Orthopaedic Surgery and Research Anterior cruciate ligament reconstruction Remnants’ preservation Animal model Rat Tendinous autograft Interference screw |
| title | Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model |
| title_full | Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model |
| title_fullStr | Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model |
| title_full_unstemmed | Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model |
| title_short | Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model |
| title_sort | remnants preserving acl reconstruction using direct tendinous graft fixation a new rat model |
| topic | Anterior cruciate ligament reconstruction Remnants’ preservation Animal model Rat Tendinous autograft Interference screw |
| url | https://doi.org/10.1186/s13018-021-02890-9 |
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