Effect of Early and Delayed Mechanical Loading on Tendon-to-Bone Healing After Anterior Cruciate Ligament Reconstruction by Asheesh Bedi, David Kovacevic,

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Effect of Early and Delayed Mechanical Loading on Tendon-to-Bone Healing After Anterior Cruciate Ligament Reconstruction by Asheesh Bedi, David Kovacevic, Alice J.S. Fox, Carl W. Imhauser, Mark Stasiak, Jonathan Packer, Robert H. Brophy, Xiang-Hua Deng, and Scott A. Rodeo J Bone Joint Surg Am Volume 92(14): October 20, 2010 ©2010 by The Journal of Bone and Joint Surgery, Inc.

Study design. Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Surgical technique. Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

A: A novel computer-controlled loading device was developed to interface with the connectors of the external fixator and apply axial distraction or compression to the tibiofemoral joint, parallel to the graft tunnels, thereby enabling the application of axi... Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Significantly more ED2+ resident macrophages were observed at the tendon-bone interface of both delayed-loading groups compared with the number in the immediate-loading or immobilization group at two and four weeks postoperatively (p < 0.02). Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Quantitative immunohistochemical analysis with smooth-muscle-actin (SMA) staining revealed reduced interface tissue vascularity in both delayed-loading groups compared with that in the immediate-loading or immobilization group at two and four weeks postoper... Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Sagittal micro-computed tomography images of the tibial tunnel. Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Significantly greater new-bone volume (NBV) was observed in the tibial tunnels of both delayed- loading groups compared with that in the immediate-loading or immobilization group at two and four weeks postoperatively (p < 0.003). Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

A significantly greater ultimate load to failure of the bone-tendon-bone complex was observed in the late (postoperative-day-10) delayed-loading groups compared with that in the immediate- loading or immobilization group at two weeks postoperatively (p < Asheesh Bedi et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.