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A histomorphological study of tendon reconstruction to a hydroxyapatite‐coated implant: Regeneration of a neo‐enthesis in vivo
Author(s) -
Pendegrass C. J.,
Oddy M. J.,
Can S. R.,
Briggs T.,
Goodship A. E.,
Blunn G. W.
Publication year - 2004
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1016/j.orthres.2004.03.022
Subject(s) - enthesis , implant , tendon , osseointegration , biomedical engineering , materials science , soft tissue , patellar tendon , anatomy , regeneration (biology) , medicine , surgery , biology , microbiology and biotechnology
The attachment of tendons and ligaments to massive endoprostheses remains a clinical challenge due to the difficulty in achieving a soft tissue implant interface with a mechanical strength sufficient to transmit the forces necessary for locomotion. We have used an in vivo animal model to study patellar tendon attachment to an implant surface. The interface generated when the patellar tendon was attached to a hydroxyapatite (HA) coated implant was examined using light microscopy and a quantitative histomorphological analysis was performed. In the Autograft Group, the interface was augmented with autogenous cancellous bone and marrow graft, and at six weeks an indirect‐like insertion was observed. At twelve weeks, the interface was observed to be a layered neo‐enthesis, whose morphology was similar to a normal direct tendon insertion. In the HA Group, the tendon–implant interface was not augmented, and the implant was enveloped by a dense collagenous fibrous tissue. This study shows that a tendon–implant neo–enthesis can develop in situ by employing a suitable implant surface in association with biological augmentation. © 2004 Orthopaedic Research Society. Published y Elsevier Ltd. All rights reserved.