Area, length and mineralization content of new bone at bone-tendon junction predict its repair quality

We investigated the hypothesis that if the area, length, and mineralization of newly formed bone could be used to predict the healing quality of patella-patellar tendon (PPT) junction after partial patellectomy. Twenty-four rabbits underwent partial patellectomy and their PPT complexes of the operated limbs were harvested at weeks 6, 12, and 18 postoperatively. The area, length, and mineralization of newly formed bone at PPT junction healing interface was evaluated radiographically and peripheral quantitative computational tomographically. The healing quality of PPT complexes in terms of its tensile property was determined by biomechanical testing. The results showed that the area, length, and mineral content of newly formed bone, and its tensile strength increased significantly with follow-up time. The area of newly formed bone was strongly correlated with the failure load, ultimate strength and energy at failure (r = 0.75, 0.76, and 0.70, respectively, p < 0.01 for all). The length of newly formed bone was also found to be correlated with failure load, ultimate strength and energy at failure (r = 0.61, 0.54, 0.67, respectively, p < 0.01 for all). In addition, the bone mineral content of newly formed bone but not its bone mineral density was moderately correlated with failure load, ultimate strength and energy at failure (r = 0.44, 0.51, 0.42, respectively, p < 0.05 for all). In conclusion, the area, length, and mineralization of newly formed bone at the PPT junction after partial patellectomy may serve as useful noninvasive indices in assessing the quality of the bone-tendon junction repair.