The fibrocartilage transition zone in the direct bone-tendon junction reduces stress concentration and protects the junction
from failure. Unfortunately, bone-tendon junctions often heal without fibrocartilage transition zone regeneration. We hypothesized
articular cartilage grafts could increase fibrocartilage transition zone regeneration. Using a goat partial patellectomy repair
model, autologous articular cartilage was harvested from the excised distal third patella and interposed between the residual
proximal two-thirds bone fragment and tendon during repair in 36 knees. We evaluated fibrocartilage transition zone regeneration,
bone formation, and mechanical strength after repair at 6, 12, and 24 weeks and compared them with direct repair. Autologous
articular cartilage interposition resulted in more fibrocartilage transition zone regeneration (69.10% ± 14.11% [mean ± standard
deviation] versus 8.67% ± 7.01% at 24 weeks) than direct repair at all times. There was no difference in the amount of bone
formation and mechanical strength achieved. Autologous articular cartilage interposition increases fibrocartilage transition
zone regeneration in bone-tendon junction healing, but additional research is required to ascertain the mechanism of stimulation
and to establish the clinical applicability.
One or more of the authors (MWNW, LQ, KSL) have received funding from Research Grants Council Earmarked Grant (Ref. CUHK 427597M).
Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research.