Affiliation:
1. N.V. Sklifosovsky Research Institute of Emergency Medicine
2. N.V. Sklifosovsky Research Institute of Emergency Medicine; Moscow Aviation Institute (National Research University)
3. N.V. Sklifosovsky Research Institute of Emergency Medicine; N.I. Pirogov Russian National Research Medical University
4. N.V. Sklifosovsky Research Institute of Emergency Medicine; A.I. Evdokimov Moscow State University of Medicine and Density
5. S.S. Yudin City Clinical Hospital
Abstract
Allogeneic tendon grafts are seriously demand in knee joint plastic surgery. The novel method of tendon cryopreservation, including sterilization with supercritical carbon dioxide, was developed in N.V. Sklifosovsky Research Institute for Emergency Cryopreserved tendons retain their normal fiber structure without significant loss of mechanical properties. At the next stage it was necessary to evaluate cryopreserved tendons′ integration inside bone canal in experimental animals.The aim of study. To evaluate morphologic changes of autologous and allogeneic tendons inside the femur in rats and to determine the effect of tendon transplantation on the physical activity.Material and methods. The study was conducted on white inbreed male rats. Three groups of animals were formed: the control group (animals without tendon transplantation), the 1st experimental group – animals with autologous tendon transplantation, the 2nd experimental group – animals with allogeneic tendon transplantation. In animals of the experimental groups the through channel was formed in the distal metaepiphysis of the femur and a tail tendon graft 0.5 x 0.1 cm was placed there. To assess the physical activity of the animals, we studied maximum distance that the animals could run 3 and 6 weeks after transplantation was determined, using treadmill test. The graft structure was evaluated on histological preparations in transmitted light, stained with hematoxylin-eosin and Van Gieson′s stain. To assess the preservation of collagen fibers we checked the autofluorescence intensity of collagen.Results. According to the treadmill test, the distance run by the animals of both experimental groups did not significantly differ from the values in the control group. Histological analysis after 3 weeks in both experimental groups revealed signs of fibers′ decomposition in the absence of inflammatory infiltration and maintaining close contact with bone trabeculae. The autofluorescence intensity of the collagen fibers in grafts corresponded to normal or was close to normal. After 6 weeks, the animals of both experimental groups revealed areas of graft fusion with their own bone, Sharpe fibers were actively formed. In both groups, numerous small vessels with diameters up to 10 microns were detected in the area of tendon-bone contact. Infiltration of grafts by inflammatory cells was absent or very insignificant, active migration of fibroblasts to the tendon area was also not observed. In both groups, tendon grafts had areas where fiber decompactization was observed. In the area of contact with the bone, the autofluorescence of tendon fibers was sharply increased, which indicates the chemical cleavage of collagen. At 3 and 6 weeks after transplantation the effect of fixation (integration) of the tendon with bone tissue was observed in both experimental groups.Conclusions. Allogeneic tendon grafts did not cause a pronounced inflammatory or immune reaction in experimental animals. 6 weeks after transplantation of autologous and allogeneic tendons, the integration of grafts inside the femoral canal was observed. Cryopreserved allogeneic tendons were able to integrate into the body's own tissues without pronounced structural and functional disorders. According to the treadmill test, the distance covered by the animals of both experimental groups did not differ statistically significantly from the values in the control group (without tendon transplantation) after 3 and 6 weeks
Publisher
Reaviz Medical University
Reference14 articles.
1. Pupynin D.Y., Lychagin A.V., Gritsyuk A.A., The results of the application of dynamic intraligamentous stabilization in case of rupture of the anterior cruciate ligament. Department of Traumatology and Orthopedics. 2022; 4: 45-51 doi: 10.17238/2226-2016-2022-4-45-51 (in Russian).
2. Dai W, Leng X, Wang J, Cheng J, Hu X, Ao Y. Quadriceps Tendon Autograft Versus Bone-Patellar Tendon-Bone and Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Am J Sports Med. 2022; 50(12): 3425-3439. doi: 10.1177/03635465211030259.
3. Rousseau R., Labruyere C., Kajetanek C., Deschamps O., Makridis K.G., Djian P. Complications After Anterior Cruciate Ligament Reconstruction and Their Relation to the Type of Graft: A Prospective Study of 958 Cases. Am. J. Sports Med. 2019; 47: 2543–2549. doi: 10.1177/0363546519867913
4. Runer A, Csapo R, Hepperger C, Herbort M, Hoser C, Fink C. Anterior Cruciate Ligament Reconstructions With Quadriceps Tendon Autograft Result in Lower Graft Rupture Rates but Similar Patient-Reported Outcomes as Compared With Hamstring Tendon Autograft: A Comparison of 875 Patients. Am J Sports Med. 2020; 48(9): 2195-2204. doi: 10.1177/0363546520931829.
5. Shangina O.R., Bulgakova L.A. Structural peculiarities of lyophilized tissues and possibilities of their clinical application. Practicheskaya Medicina. 2019; 17(1): 20-23 (in Russian).