Abstract
To analyze the effects of stress-shielding on graft maturation after the anterior cruciate ligament (ACL) reconstruction, autogenous ACL reconstruction using Achilles tendon was performed in rabbits. Two-end fixation with a ligament augmentation device (LAD), as a stress-shielding model (SS group), and pull-out fixation with Leeds-Keio artificial ligaments (L-K ligament), as a non-stress-shielding model (non-SS group), were investigated. Intact ACL was used as the control. Specimens were harvested 6 mon postoperatively, and the analysis was focused on collagen fibril maturation in the mid-substance and bone-anchoring pattern in the bone tunnel, under light and transmission electron microscopy. The density of collagen fibrils in the control was lower than that in both experimental groups (p<0.01). The per cent collagen area in the control was higher than that in the SS (p<0.01) and the non-SS group (p<0.01). The per cent collagen area in the non-SS group was higher than that in the SS group (p<0.05). At the ligament-bone interface, intracellular calcification of the degenerated chondrocytes occurred in the non-SS group, while in the SS group hydroxyapatite deposits were observed only in the extracellular matrix. These results show unfavorable influence of stress-shielding on graft maturation not only in the mid-substance but also at the ligament-bone junction. © 1999 Kluwer Academic Publishers
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
W. C. Campbell, Am. J. Surg. 43 (1939) 473.
E. Eriksson, Orthop. Clin. North. Am. 7 (1976) 167.
K. Jones, J. Bone Joint Surg. 64-A (1963) 925.
D. Macintosh, ibid. 56-B (1974) 591.
L. E. Paulos, D. L. Butler, F. R. Noyes and E. S. Grood, Clin. Orthop. 172 (1983) 78.
R. A. Harter, Am. J. Sports Med. 16 (1988) 434.
T. D. Rosenberg, J. L. Franklin, G. N. Baldwin and K. A. Nelson, ibid. 20 (1992) 525.
K. Shino, S. Nakagawa, M. Inoue, S. Horiba and M. Yoneda, ibid. 21 (1993) 206.
K. Yasuda, ibid. 20 (1992) 471.
D. M. Daniel, in “Orthopaedic knowledge update 3” edited by W. B. Greene, (AAOS, Rosemont, 1990) p. 557.
J. C. Kennedy, Clin. Orthop 172 (1983) 125.
W. G. Clancy, M. S. Narechania, T. D. Rosen-berg, J. G. Gme iner and T. A. Lange, J. Bone Joint Surg. 63-A (1981) 1270.
R. R. Cooper and S. Misol, ibid. 52-A (1970) 1.
A. D. Forword and R. J. Corwan, ibid. 45-A (1963) 807.
M. Hausman, S. Bain and C. Rubin, Trans. Orthop. Res. Soc. 14 (1989) 277.
G. A. Kernwein, Surg. Gynec. Obstet. 75 (1942) 794.
P. K. Nikolaou, A. V. Seaber, R. R. Glisson, B. M. Ribbeck and F. H. Bassett, Am. J. Sports Med. 14 (1986) 348.
S. A. Rodeo, S. P. Amoczky, P. A. Torzilli, C. Hidaka and R. F. Warren, J. Bone Joint Surg. 75-A (1993) 1795.
T. B. Whi ston and R. Walmsley, ibid. 42-B (1960), 377.
K. Fuj ikawa, in “Prosthetic ligament reconstruction of the knee” edited by M. J. Friedman and R. D. Ferkel (Saunders Philadelphia, PA, 1988) p. 132.
K. Fujikawa, F. I Seki and B. B. Seedhom, J. Bone Joint Surg. 71-B (1989) 566.
B. W. Oakes, M. Knight, I. D. Mclean and O. Deacon, in “Proceedings of AOSSM”, San Diego (1992) p. 45.
D. W. Jackson, E. S. Grood, J. Goldstein, M. A. Rosen, P. R. Kurzweil, J. F. Cummings and T. M. Simon, Am. J. Sports Med. 21 (1993) 176.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Itoh, S., Muneta, T., Shinomiya, K. et al. Electron microscopic evaluation of the effects of stress-shielding on maturation of the mid-substance and ligament-bone junction of the reconstructed anterior cruciate ligament in rabbits. Journal of Materials Science: Materials in Medicine 10, 185–190 (1999). https://doi.org/10.1023/A:1008945709532
Issue Date:
DOI: https://doi.org/10.1023/A:1008945709532