| Purpose: To investigate the initial fixation effect and histological outcome of anterior cruciate ligament ( ACL) reconstruction with tendon knots and bone-tendon autograft implant fixation. Material and Method: Forty-five porcine knees were classified into 4 groups randomly: 1. Tendon knots implant fixation;2. Bone-tendon implant fixation;3. Interference screw fixation of B-PT-B;4. Normal porcine knees as control. Maximum pullout strength, stiffness, and translation were statistically observed as parameters. Goats were chosen as the animal models. A customized reamer was used to built the bottleneck-like femoral tunnel and the patellar tendon-tibial tuberosity bone block or extensor digitorum longus tendon knots were press-fitted as the autografts, respectively. Animals were killed at 4, 8, 12, and 16 weeks postoperatively. Radiological, macromorphological, and histological outcomes were investigated. Results: Biomechanical evaluation showed that implant fixation of tendon knots and bone-tendon graft constructs had superior maximum pullout strength than B-PT-B group, which might meet physiological demand of the knee. Histological studies showed incorporation between bone tunnel and tendon graft 12 weeks postoperatively. From 4-16 weeks, the area of vascular increased gradually. Conclusion: Anterior cruciate ligament reconstruction with with tendon knots and bone-tendon autograft implant fixation exhibited satisfied biological and biomechanical results, some parameters even better than B-PT-B graft. This research may afford valuable information on clinical application and postoperative rehabilation.
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