Our study evaluated tendon-to-bone healing in a dog model. Twenty adult
mongrel dogs had a transplantation of the long digital extensor tendon into
a 4.8-millimeter drill-hole in the proximal tibial metaphysis. Four dogs
were killed at each of five time-periods (two, four, eight, twelve, and
twenty-six weeks after the transplantation), and the histological and
biomechanical characteristics of the tendon-bone interface were evaluated.
Serial histological analysis revealed progressive reestablishment of
collagen-fiber continuity between the bone and the tendon. A layer of
cellular, fibrous tissue was noted between the tendon and the bone, along
the length of the bone tunnel; this layer progressively matured and
reorganized during the healing process. The collagen fibers that attached
the tendon to the bone resembled Sharpey fibers. High-resolution
radiographs showed remodeling of the trabecular bone that surrounded the
tendon. At the two, four, and eight-week time-periods, all specimens had
failed by pull-out of the tendon from the bone tunnel. The strength of the
interface was noted to have significantly and progressively increased
between the second and the twelfth week after the transplantation. At the
twelve and twenty-six-week time-periods, all specimens had failed by
pull-out of the tendon from the clamp or by mid-substance rupture of the
tendon. The progressive increase in strength was correlated with the degree
of bone ingrowth, mineralization, and maturation of the healing tissue,
noted histologically.