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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 4, 535-541.
doi: 10.1302/0301-620X.90B4.20345  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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A comparison of augmentation techniques for reconstruction of the extensor mechanism following proximal tibial replacement in an experimental animal model

C. J. Pendegrass, BSc, PhD, Research Fellow1; S. Sundar, BSc, PhD, Student1; M. J. Oddy, FRCS(Orth), Orthopaedic Surgeon1; S. R. Cannon, FRCS(Orth), Orthopaedic Surgeon1; T. Briggs, FRCS(Orth), Orthopaedic Surgeon1; and G. W. Blunn, BSc, PhD, Professor1

1 The Centre for Biomedical Engineering The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Correspondence should be sent to Dr C. J. Pendegrass; e-mail: c.pendegrass{at}ucl.ac.uk

We used an in vivo model to assess the use of an autogenous cancellous bone block and marrow graft for augmenting tendon reattachment to metallic implants. We hypothesised that augmentation of the tendon-implant interface with a bone block would enable retention of the graft on the implant surface, enhance biological integration, and result in more consistent functional outcomes compared with previously reported morcellised graft augmentation techniques.

A significant improvement in functional weight-bearing was observed between six and 12 weeks. The significant increase in ground reaction force through the operated limb between six and 12 weeks was greater than that reported previously with morcellised graft augmented reconstructions. Histological appearance and collagen fibre orientation with bone block augmentation more closely resembled that of an intact enthesis compared with the morcellised grafting technique. Bone block augmentation of tendon-implant interfaces results in more reliable functional and histological outcomes, with a return to pre-operative levels of weight-bearing by 24 weeks.




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S. Sundar, C. J. Pendegrass, M. J. Oddy, and G. W. Blunn
Tendon re-attachment to metal prostheses in an in vivo animal model using demineralised bone matrix
J Bone Joint Surg Br, September 1, 2009; 91-B(9): 1257 - 1262.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General