Revascularization in the tendon graft following anterior cruciate ligament reconstruction of the knee: its mechanisms and regulation.

In anterior cruciate ligament (ACL) reconstruction, slow graft maturation may result in graft failure or elongation during the postoperative rehabilitation period. Vascular endothelial growth factor (VEGF) is a potent mediator of angiogenesis. The findings of recent studies suggest that VEGF application is a potential strategy to accelerate angiogenesis in the graft after ACL reconstruction. However, the biomechanical results indicate that exogenous VEGF application decreases the stiffness of the grafted tendon at least temporarily. Therefore, we should take into account this adverse effect of exogenous VEGF application on the mechanical characteristics of the grafted tendon.