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From the * Department of Orthopaedic Surgery, National University of Singapore, and the Division of Bioengineering, National University of Singapore
Address correspondence to James C. H. Goh, Department of Orthopaedic Surgery, National University of Singapore, 10 Lower Kent Ridge Road, Singapore 119260.
Background: Despite increasing attention on the issue of tendon-to-bone integration, there has been no animal study on the use of cell therapy for promoting the insertion healing of tendon to bone.
Purpose: To determine the efficacy of using a large number of bone marrow stromal cells (bMSCs) to enhance tendon-to-bone healing.
Study Design: Controlled laboratory study.
Methods: The hallucis longus tendons were translated into 2.5-mm diameter calcaneal bone tunnels in a New Zealand white rabbit model. The bone tunnels were treated with or without bMSCs. Three specimens from each group were harvested at 2, 4, and 6 weeks postoperatively and evaluated by conventional histological and immunohistochemical methods.
Results: At 4 weeks, the specimens with bMSCs exhibited more perpendicular collagen fiber formation and increased proliferation of cartilage-like cells, which was indicated by positive collagen type-II immuno-staining of the tendon-bone interface. In contrast, the specimens without bMSCs demonstrated progressive maturation and reorganization of fibrous tissue aligned along the load axis.
Conclusion: Introduction of a large number of bone marrow stromal cells to the bone tunnel have shown to improve the insertion healing of tendon to bone in a rabbit model through formation of fibrocartilagenous attachment at early time points.
Key Words: bone marrow stromal cell • tendon-to-bone healing • fibrocartilagenous insertion • cell therapy
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