
handle: 10852/77741
Intra-articular ligament injuries are common in the younger and more active part of the population. These injuries often require surgical reconstruction to restore joint stability due to lack of healing potential. The success of a ligament reconstruction depends on several elements, including biological healing of musculoskeletal tissue. Graft incorporation by tendon to bone healing and the remodeling of the tendon, are crucial to restore and maintain joint stability following a ligament reconstruction. This project aimed to investigate aspects of tendon to bone healing and tendon graft augmentation in ligament reconstruction. Clinicals registry data and in vivo studies enabled evaluation of different timepoints in the healing and remodeling process of intra-articular ligament reconstructions. Local administration of bone anabolic reagents (GSK126 compared to BMP-2) were evaluated for their potentially enhancing effect on tendon to bone healing in an in vivo model. Our findings indicate that these agents have the potential to enhance tendon to bone tunnel healing in ligament reconstructions, although the results did not reflect significantly enhanced biomechanical outcomes or new bone formation. The use of a synthetic suture tape on its own, or as a tendon graft augmentation, in an early phase of intra-articular ligament reconstruction was investigated using an in vivo model in rabbits. This study demonstrated increased biomechanical properties in joints with suture tape, compared to tendon graft alone. In addition, as the suture tape did not negatively affect new bone formation in the bone tunnels or invoke prolonged inflammation, it appears to be safe for use in intra-articular reconstruction within the time frames of this study. Pre-clinical studies have demonstrated a negative effect of non-steroidal anti-inflammatory drugs (NSAIDs) on musculoskeletal tissue healing, such as tendon to bone healing. Data from the Norwegian Knee Ligament Registy were evaluated to assess the effect of NSAIDs on an intra-articular ligament reconstruction. Our analysis showed that limited peri-operative administration of NSAIDs to patients undergoing anterior cruciate ligament reconstruction does not reduce graft survival, or increase the risk for either revision or poor functional outcome.
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