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Lin YY, Jbeily EH, Tjandra PM, Pride MC, Lopez-Torres M, Elmankabadi SB, Delman CM, Biris KK, Bang H, Silverman JL, Lee CA, Christiansen BA. Surgical restabilization reduces the progression of post-traumatic osteoarthritis initiated by ACL rupture in mice. Osteoarthritis Cartilage 2024:S1063-4584(24)01170-1. [PMID: 38697509 DOI: 10.1016/j.joca.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 02/29/2024] [Accepted: 04/02/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE People who sustain joint injuries such as anterior cruciate ligament (ACL) rupture often develop post-traumatic osteoarthritis (PTOA). In human patients, ACL injuries are often treated with ACL reconstruction. However, it is still unclear how effective joint restabilization is for reducing the progression of PTOA. The goal of this study was to determine how surgical restabilization of a mouse knee joint following non-invasive ACL injury affects PTOA progression. DESIGN In this study, 187 mice were subjected to non-invasive ACL injury or no injury. After injury, mice underwent restabilization surgery, sham surgery, or no surgery. Mice were then euthanized on day 14 or day 49 after injury/surgery. Functional analyses were performed at multiple time points to assess voluntary movement, gait, and pain. Knees were analyzed ex vivo with micro-computed tomography, RT-PCR, and whole-joint histology to assess articular cartilage degeneration, synovitis, and osteophyte formation. RESULTS Both ACL injury and surgery resulted in loss of epiphyseal trabecular bone (-27-32%) and reduced voluntary movement at early time points. Joint restabilization successfully lowered OA score (-78% relative to injured at day 14, p < 0.0001), and synovitis scores (-37% relative to injured at day 14, p = 0.042), and diminished the formation of chondrophytes/osteophytes (-97% relative to injured at day 14, p < 0.001, -78% at day 49, p < 0.001). CONCLUSIONS This study confirmed that surgical knee restabilization was effective at reducing articular cartilage degeneration and diminishing chondrophyte/osteophyte formation after ACL injury in mice, suggesting that these processes are largely driven by joint instability in this mouse model. However, restabilization was not able to mitigate the early inflammatory response and the loss of epiphyseal trabecular bone, indicating that these processes are independent of joint instability.
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Affiliation(s)
- Yu-Yang Lin
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Elias H Jbeily
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Priscilla M Tjandra
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Michael C Pride
- University of California Davis Health, Department of Psychiatry and Behavioral Sciences, 4625 2nd Ave, Sacramento, CA 95817, USA
| | - Michael Lopez-Torres
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Seif B Elmankabadi
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Connor M Delman
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Kristin K Biris
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Heejung Bang
- University of California Davis Health, Department of Public Health Sciences, Medical Sciences 1C, Davis, CA 95616, USA
| | - Jill L Silverman
- University of California Davis Health, Department of Psychiatry and Behavioral Sciences, 4625 2nd Ave, Sacramento, CA 95817, USA
| | - Cassandra A Lee
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA
| | - Blaine A Christiansen
- University of California Davis Health, Department of Orthopaedic Surgery, Lawrence J. Ellison Musculoskeletal Research Center, 2700 Stockton Blvd, Suite 2301, Sacramento, CA 95817, USA.
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Remnants-preserving ACL reconstruction using direct tendinous graft fixation: a new rat model. J Orthop Surg Res 2022; 17:7. [PMID: 34986843 PMCID: PMC8729105 DOI: 10.1186/s13018-021-02890-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022] Open
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.
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Santoso ARB, Mustamsir E, Luqman Fadli M, Yuarno Phatama K, Wijaya AEP, Dhakka Siahaan L, Sugiarto A. The Effects of Stromal Vascular Fraction Administration in Stimulating Graft Healing Process after Anterior Cruciate Ligament Reconstruction Surgery in Rattus norvegicus. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Ligament injuries commonly occur in the knee region, and the anterior cruciate ligament (ACL) being the most usually injured. Currently, autograft or allograft is the most common material used for ACL reconstruction surgery. The result of the ACL reconstruction depends on the healing process of the graft or ligamentization between graft and bone tunnel. This study aims to evaluate the effect of Stromal Vascular Fraction (SVF) intratunnel injection to stimulates graft healing following ACL reconstruction surgery, as measured by histology examination.
Method: This study was an experimental laboratory study with a post-test-only control group design using male Rattus novergicus. A random sampling procedure was used to choose the sample, which was then divided into two groups. The two groups consist of the control group that only had ACL reconstruction surgery and the treatment group that had reconstruction surgery with SVF administration.
Result: This study used Advanced Ligament Maturity Index (LMI) score and showed a significant improvement of graft healing in the treatment group compared to the control group. The measurement is based on the cellular, collagen, and vascular aspect testing with P < 0,05 for each subscore.
Conclusion: SVF intratunnel injection stimulates graft healing after ACL reconstruction surgery and causes a significant increase in cellular, collagen, and vascular aspects in the graft.
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Leong NL, Kabir N, Arshi A, Nazemi A, Wu B, Petrigliano FA, McAllister DR. Evaluation of polycaprolactone scaffold with basic fibroblast growth factor and fibroblasts in an athymic rat model for anterior cruciate ligament reconstruction. Tissue Eng Part A 2015; 21:1859-68. [PMID: 25744933 DOI: 10.1089/ten.tea.2014.0366] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Anterior cruciate ligament (ACL) rupture is a common ligamentous injury often necessitating surgery. Current surgical treatment options include ligament reconstruction with autograft or allograft, which have their inherent limitations. Thus, there is interest in a tissue-engineered substitute for use in ACL regeneration. However, there have been relatively few in vivo studies to date. In this study, an athymic rat model of ACL reconstruction was used to evaluate electrospun polycaprolactone (PCL) grafts, with and without the addition of basic fibroblast growth factor (bFGF) and human foreskin fibroblasts. We examined the regenerative potential of tissue-engineered ACL grafts using histology, immunohistochemistry, and mechanical testing up to 16 weeks postoperatively. Histology showed infiltration of the grafts with cells, and immunohistochemistry demonstrated aligned collagen deposition with minimal inflammatory reaction. Mechanical testing of the grafts demonstrated significantly higher mechanical properties than immediately postimplantation. Acellular grafts loaded with bFGF achieved 58.8% of the stiffness and 40.7% of the peak load of healthy native ACL. Grafts without bFGF achieved 31.3% of the stiffness and 28.2% of the peak load of healthy native ACL. In this in vivo rodent model study for ACL reconstruction, the histological and mechanical evaluation demonstrated excellent healing and regenerative potential of our electrospun PCL ligament graft.
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Affiliation(s)
- Natalie Luanne Leong
- 1Department of Orthopedic Surgery, University of California, Los Angeles, Los Angeles, California
| | - Nima Kabir
- 1Department of Orthopedic Surgery, University of California, Los Angeles, Los Angeles, California
| | - Armin Arshi
- 1Department of Orthopedic Surgery, University of California, Los Angeles, Los Angeles, California
| | - Azadeh Nazemi
- 2Department of Bioengineering, University of California, Los Angeles, Los Angeles, California
| | - Ben Wu
- 2Department of Bioengineering, University of California, Los Angeles, Los Angeles, California
| | - Frank A Petrigliano
- 1Department of Orthopedic Surgery, University of California, Los Angeles, Los Angeles, California
| | - David R McAllister
- 1Department of Orthopedic Surgery, University of California, Los Angeles, Los Angeles, California
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