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To investigate the mechanism by which bone tunnel mechanical microenvironment optimization enhances tendon-bone healing after anterior cruciate ligament reconstruction, with a focus on the TAK1/NF-κB/MAPK signaling pathway
Received date: 2025-11-24
Online published: 2026-03-09
Objective To explore the facilitative effect of optimizing the mechanical microenvironment of the bone tunnel on tendon-bone healing after anterior cruciate ligament (ACL) reconstruction, and its regulatory correlation with the Transforming growth factor-β-activated kinase 1 (TAK1)/Nuclear factor kappa-B (NF-κB)/Mitogen-activated protein kinase (MAPK) signaling pathway. Methods A rabbit model of anterior cruciate ligament (ACL) reconstruction was established and randomly allocated into four groups: the normal control (NC) group, the conventional forward drilling without bone grafting (FD) group, the forward drilling plus bone grafting (FD + BG) group, and the reverse drilling plus bone grafting (RD + BG) group. Hematoxylin-eosin (HE) staining was carried out to observe the histomorphological changes at the tendon-bone interface. Quantitative real-time polymerase chain reaction (qRT-PCR) was utilized to detect the messenger ribonucleic acid (mRNA) expressions of inflammatory factors interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Enzyme-linked immunosorbent assay (ELISA) was applied to measure the concentrations of the angiogenesis-related factor vascular endothelial growth factor (VEGF) and the tissue repair factor transforming growth factor-β1 (TGF-β1). Western blot analysis was performed to evaluate the protein expressions of osteogenic factors osteocalcin (OCN), osteopontin (OPN), and key proteins in the TAK1/NF-κB/MAPK signaling pathway. Results Histomorphological findings indicated that the RD + BG group achieved the most optimal tendon-bone interface fusion, characterized by dense and mature newly-formed bone trabeculae. When compared with the FD + BG group, the RD + BG group showed significantly downregulated mRNA expressions of IL-6 and TNF-α, remarkably upregulated levels of VEGF, TGF-β1, along with protein expressions of OCN and OPN, and notably decreased phosphorylation ratios of key proteins in the TAK1/NF-κB/MAPK pathway (p-TAK1/TAK1, p-p65/p65, p-p38/p38) (P < 0.05). Conclusion Optimization of the bone tunnel mechanical microenvironment (RD + BG) can effectively balance local inflammatory responses, precisely upregulate the expressions of repair-related and osteogenic factors, and consequently accelerate tendon-bone healing after ACL reconstruction. This process might be closely associated with the activation changes of the TAK1/NF-κB/MAPK signaling pathway, offering novel experimental evidence for the clinical refinement of ACL reconstruction surgery.
Fuguo SHEN , Wenlong XIAO , Wencai SUN , Song JIN , Dongmei CUI . To investigate the mechanism by which bone tunnel mechanical microenvironment optimization enhances tendon-bone healing after anterior cruciate ligament reconstruction, with a focus on the TAK1/NF-κB/MAPK signaling pathway[J]. The Journal of Practical Medicine, 2026 , 42(5) : 807 -813 . DOI: 10.3969/j.issn.1006-5725.2026.05.011
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