AKSELERASI GRAFT TUNNEL HEALING PADA REKONSTRUKSI ANTERIOR CRUCIATE LIGAMENT MENGGUNAKAN AUTOGRAF TENDON HAMSTRING DENGAN TRANSPLANTASI ALLOGENIC BM-MSCs – VEGF SECARA INTRATUNNEL PENELITIAN EKSPERIMENTAL LABORATORIS
Background : Anterior cruciate ligament (ACL) injury is one of the most common knee injuries that occurs as a result of sport or physical exercise. ACL reconstruction is the gold standard of treatment for ACL injury using tendon graft. The process of tissue formation between the tendon graft and...
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| Format: | Theses and Dissertations NonPeerReviewed |
| Language: | Indonesian Indonesian |
| Published: |
2016
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| Subjects: | |
| Online Access: | http://repository.unair.ac.id/58242/1/Dis%20K.%2023-16%20Set%20a%20abstrak.pdf http://repository.unair.ac.id/58242/2/Dis%20K.%2023-16%20Set%20a.pdf http://repository.unair.ac.id/58242/ http://lib.unair.ac.id |
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| Institution: | Universitas Airlangga |
| Language: | Indonesian Indonesian |
| Summary: | Background : Anterior cruciate ligament (ACL) injury is one of the most
common knee injuries that occurs as a result of sport or physical exercise. ACL
reconstruction is the gold standard of treatment for ACL injury using tendon graft.
The process of tissue formation between the tendon graft and the bone is an
important link at the early stage of healing process. The combination of
intratunnel allogenic Bone Marrow-Mesenschymal Stem Cells (BM-MSCs) and
Vascular Endothelial Growth Factor (VEGF) is able to improve the
microenviroment, as well as stimulate cell proliferation, differentiation and matrix
deposition by enhancing angiogenesis and osteogenesis of the graft in the tunnel.
Objective : The objective of this study is to prove the transplantation of
Intratunnel Allogenic BM-MSCs and VEGF is able to enhance the early graft
tunnel healing in ACL reconstruction by using autograft hamstring tendon.
Methods : A controlled animal study was promoted by using four group of
rabbits which underwent bilateral ACL reconstruction with semitendinosus
tendon, then transplanted with intratunnel allogenic BM-MSCs and VEGF. The
treatment was divided into two groups which based on the time of healing process
evaluation, in 3 and 6 weeks. Then the graft tunnel healing was analyzed by
evaluating the number of capillaries, the surface area of cells expressing ALP,
collagen type I and collagen type III, the number of Sharpey like fiber, signal
intensity of tendon graft, the width of tendon bone interface and pullout strength
test.
Results : All parameters have indicated to increase more in the treated groups
with intratunnel allogenic BM-MSCs and VEGF than the control groups without.
There were significant differences of the surface area of cells in expressing ALP,
collagen type I and type III, tendon graft signal intensity, and pullout strength, as
well as bone tendon interface between treated and control groups. However,
there were no significant differences in the number of capillaries (p=0,275) as
well as Sharpey like fiber (p=0,052). The two treated groups has showed no
differences in all variables studied.
Conclusion : The transplantation of intratunnel allogenic BM-MSC and VEGF
after ACL reconstruction has accelerated the graft tunnel healing as early as 3
weeks after surgery.
Key words : Graft tunnel healing, Anterior cruciate ligament, Bone marrow
mesenchymal stem cells, Vascular endothelial growth factor. |
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