TY - JOUR
T1 - Enveloping of periosteum on the Hamstring Tendon graft in anterior cruciate ligament reconstruction
AU - Chen, Chih Hwa
AU - Chen, Wen Jer
AU - Shih, Chun Hsiung
PY - 2002
Y1 - 2002
N2 - Tendon-bone incorporation of a tendon graft within the bone tunnel is a major concern when using tendon graft for ligament reconstruction. Periosteum consists of multipotent mesodermal cells to form all varieties of connective tissue, including osteogenic and chondrogenic tissues. From our histologic and biomechanical studies in animals, a superior healing process and stronger healing strength can be achieved when periosteum is sutured onto the tendon inserted within a bone tunnel. We applied this idea to anterior cruciate ligament reconstruction to enhance tendon-bone healing. A quadruple-stranded hamstring tendon graft is used. A piece of periosteum, 3×3 cm, harvested from the anterior cortex of proximal tibia, is split into 2 rectangle flaps (1.5×3 cm each). The periosteum flaps are wrapped and sutured around the tendon graft at the portions near the femoral and tibial tunnel openings. The cambium layer is faced outside to the bone tunnel. Periosteum is easy to harvest from proximal tibia, where is a routine incision for harvesting hamstring tendons. Besides the potential for enhancement of tendon-bone healing, periosteum may be able to seal off the intraarticular opening in a very early period to avoid synovial fluid reflux into the tunnel.
AB - Tendon-bone incorporation of a tendon graft within the bone tunnel is a major concern when using tendon graft for ligament reconstruction. Periosteum consists of multipotent mesodermal cells to form all varieties of connective tissue, including osteogenic and chondrogenic tissues. From our histologic and biomechanical studies in animals, a superior healing process and stronger healing strength can be achieved when periosteum is sutured onto the tendon inserted within a bone tunnel. We applied this idea to anterior cruciate ligament reconstruction to enhance tendon-bone healing. A quadruple-stranded hamstring tendon graft is used. A piece of periosteum, 3×3 cm, harvested from the anterior cortex of proximal tibia, is split into 2 rectangle flaps (1.5×3 cm each). The periosteum flaps are wrapped and sutured around the tendon graft at the portions near the femoral and tibial tunnel openings. The cambium layer is faced outside to the bone tunnel. Periosteum is easy to harvest from proximal tibia, where is a routine incision for harvesting hamstring tendons. Besides the potential for enhancement of tendon-bone healing, periosteum may be able to seal off the intraarticular opening in a very early period to avoid synovial fluid reflux into the tunnel.
KW - Anterior cruciate ligament
KW - Arthroscopy
KW - Hamstring tendon graft
KW - Periosteum
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U2 - 10.1053/jars.2002.31961
DO - 10.1053/jars.2002.31961
M3 - Article
C2 - 11987052
AN - SCOPUS:53949115295
SN - 0749-8063
VL - 18
SP - XI-XII
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 5
ER -