Cationised gelatin and hyaluronic acid coating enhances polyethylene terephthalate artificial ligament graft osseointegr
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ORIGINAL PAPER
Cationised gelatin and hyaluronic acid coating enhances polyethylene terephthalate artificial ligament graft osseointegration in porcine bone tunnels Samson Cho & Hong Li & Chen Chen & Jia Jiang & Hongyue Tao & Shiyi Chen
Received: 14 October 2012 / Accepted: 16 October 2012 / Published online: 7 November 2012 # Springer-Verlag Berlin Heidelberg 2012
Abstract Purpose The aim of this study was to investigate whether cationised gelatin and hyaluronic acid (CH) coating could induce polyethylene terephthalate (PET) artificial ligament graft osseointegration in the bone tunnel. Methods Surface modification of PET artificial ligament graft was performed by layer-by-layer (LBL) self-assembly CH coating. Six pigs underwent anterior cruciate ligament (ACL) reconstruction on the right knees, with three pigs receiving the CH-coated PET grafts and the other three pigs non-CH-coated PET grafts as controls. They were sacrificed at three months after surgery and the graft-bone complexes were acquired for computed tomography (CT) scan and histological examination. Results CT scans showed a significant difference at the distal femoral site (p00.031) or at the distal tibial site (p00.0078), but no significant difference in the bone tunnel areas’ enlargement at other sites (p>0.05) between the CH group and the control group. Histologically, application of CH coating induced new bone formation between graft and bone at three months compared with the controls at the distal site. The interface width of the CH group was significantly lower than that of the control group at the distal femoral site (p00.0327) and at the distal tibial site (p00.0047). S. Cho : H. Li : J. Jiang : S. Chen (*) Department of Sports Medicine, Huashan Hospital, No 12, Wulumuqi Zhong Road, Shanghai 200040, People’s Republic of China e-mail: [email protected] C. Chen Department of Orthopaedics, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China H. Tao Department of Radiology, Huashan Hospital, Shanghai, People’s Republic of China
Conclusions The study has shown that CH coating on the PET artificial ligament surface has a positive biological effect in the induction of artificial ligament osseointegration within the bone tunnel at the distal site of the bone tunnel.
Introduction The LARS artificial ligament (Ligament Advanced Reinforcement System, Surgical Implants and Devices, Arc-sur-Tille, France), made of polyethylene terephthalate (PET), has been accepted as a graft choice for anterior cruciate ligament (ACL) reconstruction by many surgeons all over the world [1–3]. It is a valid alternative for treating some acute and serious cases [4]. As this type of PET ligament has hydrophobicity and chemical inertia, the graft-bone healing of the LARS artificial ligament is one of the most important concerns after implantation. By analysing ruptured ACL artificial ligaments, Guidoin et al. [5] observed a chronic inflammatory reaction with macrophages and giant cells in the polyester ligaments. In a three to five year follow-up multice
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