ArticleBioactive materials2025
Magnesium ions attenuate tendon graft fibrosis during its ligamentization after ACL reconstruction through modulation of fibroblast to myofibroblast trans-differentiation by promoting PGE2 secretion.
Article in Bioactive materials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- [Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- Biodegradable Magnesium-Based Implants in Sports Orthopedic Surgery: Advances in Alloy Design, Surface Engineering, and Translational Evidence.Bioengineering (Basel, Switzerland) · 2026Review
- [Research progress on the role and mechanism of magnesium element and magnesium materials in tendon-bone interface healing].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- Histological and Immunohistochemical Characterization of the Tibial ACL Remnant: Implications for Ligament Healing.Medicina (Kaunas, Lithuania) · 2026Article
- Effect of biodegradable magnesium foil as an anti-adhesion barrier on the healing of rat Achilles tendon.Frontiers in bioengineering and biotechnology · 2026Article
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Authors and funding
12 authors.
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Abstract
The ligamentization process of the tendon graft in anterior cruciate ligament (ACL) reconstruction is crucial for graft healing quality, thereby affecting knee joint function. Excessive scar tissue, caused by activation of trans-differentiation of fibroblasts to myofibroblasts, rather than orientated collagen fibers with normal composition and structure in the graft mid-substance seriously impacts ligamentization. The elucidation of the underlying mechanism behind the graft fibrosis may facilitate modulation of tendon graft ligamentization. Here, we show that transforming growth factor beta 1 (TGF-β1) was significantly upregulated with ligamentization process, contributing to fibroblast to myofibroblast trans-differentiation and thereby leading to impaired collagen orientation with overproduction of collagen type III. Of note, we verified that prostaglandin E2 (PGE2), a principal mediator of inflammation secreted by macrophages, significantly reversed TGF-β1-induced trans-differentiation of fibroblasts to myofibroblasts. Importantly, magnesium (Mg) ions were found to upregulate PGE2 production in macrophages, ultimately favoring inhibition of scar tissue formation and promoting expression of ligament-like phenotype in the graft mid-substance in rats. Consistently, the rats, with injection of the sodium alginate containing Mg ions into knee joint cavity, exhibited significantly improved gait performance and failure load relative to the control group. These results demonstrate the feasibility of using Mg ions to modulate tendon ligamentization in patients after ACL reconstruction.
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