{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T09:19:47Z","timestamp":1778750387264,"version":"3.51.4"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2003,3,1]],"date-time":"2003-03-01T00:00:00Z","timestamp":1046476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2003,3,1]],"date-time":"2003-03-01T00:00:00Z","timestamp":1046476800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2003,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Fixing and incorporating the tendon graft within the bone tunnel is a major concern when using grafts for ligament reconstruction. The periosteum contains multipotent stem cells and has the potential to form osteogenic and chondrogenic tissues. This study uses histologic and biomechanical analyses to examine the effect of periosteum on tendon\u2010bone healing within a bone tunnel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Type of Study:<\/jats:title>\n                    <jats:p>Experimental study in an animal model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this study, 36 adult New Zealand White rabbits were used. The long digitorum extensor tendon was transplanted into a bone tunnel of the proximal tibia. The periosteum from the proximal tibia was sutured on the surface of the tendon portion. The tendon was pulled through a drill\u2010hole in the proximal tibia and attached to the medial aspect of the tibia. Histologic examination of the tendon\u2010bone interface and biomechanical test for maximal pullout load were evaluated at 4, 8, and 12 weeks after operation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Histologic analysis of the tendon\u2010bone interface showed a fibrous layer formed between the tendon and the bone by the periosteum. This layer became progressively integrated with the tendon and bone surface during the healing process. At 4 weeks, the cancellous bone lining in the bone tunnel was interdigitated with the fibrous interface tissue. At 8 weeks, progressive new bone grew into the interface fibrous layer. At 12 weeks, collagen fibers anchored to the bone and organization with fibrocartilage formation developed between the tendon and bone. Biomechanical testing revealed higher maximal pullout strength in the periosteum\u2010enveloped group at all time points, with a statistically significant difference at 8 and 12 weeks. The periosteum\u2010treated group had a higher interface strength\u2010to\u2010length ratio and significant increase at 8 weeks and 12 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The histologic and biomechanical studies demonstrated that, if periosteum was sutured on the tendon that was transplanted within a bone tunnel, it resulted in a superior healing process and better healed strength. When doing ligament reconstruction with a tendon graft, the periosteum can be sutured to the graft to enhance tendon\u2010bone healing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1053\/jars.2003.50014","type":"journal-article","created":{"date-parts":[[2003,6,30]],"date-time":"2003-06-30T15:47:00Z","timestamp":1056988020000},"page":"290-296","source":"Crossref","is-referenced-by-count":82,"title":["Enveloping the tendon graft with periosteum to enhance tendon\u2010bone healing in a bone tunnel: A biomechanical and histologic study in rabbits"],"prefix":"10.1002","volume":"19","author":[{"given":"Chih\u2010Hwa","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Chang Gung University Taoyuan Taiwan"},{"name":"Department of Pathology Chang Gung University Taoyuan Taiwan"},{"name":"Chang Gung Memorial Hospital Department of Mechanical Engineering Chang Gung University Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen\u2010Jer","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Chang Gung University Taoyuan Taiwan"},{"name":"Department of Pathology Chang Gung University Taoyuan Taiwan"},{"name":"Chang Gung Memorial Hospital Department of Mechanical Engineering Chang Gung University Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010Hsiung","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Chang Gung University Taoyuan Taiwan"},{"name":"Department of Pathology Chang Gung University Taoyuan Taiwan"},{"name":"Chang Gung Memorial Hospital Department of Mechanical Engineering Chang Gung University Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung\u2010Yeung","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Chang Gung University Taoyuan Taiwan"},{"name":"Department of Pathology Chang Gung University Taoyuan Taiwan"},{"name":"Chang Gung Memorial Hospital Department of Mechanical Engineering Chang Gung University Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih\u2010Jung","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Chang Gung University Taoyuan Taiwan"},{"name":"Department of Pathology Chang Gung University Taoyuan Taiwan"},{"name":"Chang Gung Memorial Hospital Department of Mechanical Engineering Chang Gung University Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po\u2010Yen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Chang Gung University Taoyuan Taiwan"},{"name":"Department of Pathology Chang Gung University Taoyuan Taiwan"},{"name":"Chang Gung Memorial Hospital Department of Mechanical Engineering Chang Gung University Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,3,1]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199312000-00009"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465990270041201"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/02844317209103459"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453678308992916"},{"key":"e_1_2_2_6_1","first-page":"207","article-title":"Osteogenic capacity of periosteal grafts","volume":"12","author":"Uddstrdmer L","year":"1978","journal-title":"Scand J Plast Reconstr Surg"},{"key":"e_1_2_2_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200102000-00022"},{"key":"e_1_2_2_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199706000-00034"},{"key":"e_1_2_2_9_1","first-page":"794","article-title":"A study of tendon implantations into bone","volume":"75","author":"Kernwein GA","year":"1942","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_2_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193808000-00011"},{"key":"e_1_2_2_11_1","first-page":"143","article-title":"Tendon\u2010to\u2010bone healing of a semitendinosus tendon autograft used for ACL reconstruction in a sheep model","volume":"13","author":"Goradia VK","year":"2000","journal-title":"Am J Knee Surg"},{"key":"e_1_2_2_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465000280011901"},{"key":"e_1_2_2_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050056"},{"key":"e_1_2_2_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199405000-00040"},{"key":"e_1_2_2_15_1","first-page":"579","article-title":"An experimental study of free periosteal transplants, wrapped around tendon: With a review of the literature","volume":"12","author":"Burman MS","year":"1930","journal-title":"J Bone Joint 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