Acutely repaired proximal anterior cruciate ligament ruptures in sheep - by augmentation improved stability and reduction of cartilage damage.

The aim of this study was to evaluate the healing capacity of proximal anterior cruciate ligament (ACL) ruptures following primary repair with and without a bioresorbable augmentation. The ACL was transected at the femoral origin in the right knee joint of 24 sheep. The ACL was repaired in eight sheep (group B) without, and in eight sheep (group C) with a bioresorbable augmentation. Eight sheep without repair served as a control (group A). No immobilization was performed in any group. The sheep were sacrificed 13 weeks post-operatively. Macroscopically, all repaired ACLs were healed. The augmentation device was broken in all cases, but not completely degraded. In group A, none of the transected ACLs had healed. The anterior drawer under a load of 50 N was significantly lower in group C than in group A (p<0.01). No significant difference was seen between groups B and A. The distribution and extent of chondromalacia (CM) in the operated knees depended on the type of operative treatment (p<0.01). Groups A and B showed significantly more CM in the operated knee than in the non-operated knee (each p<0.05). Proximal ACL ruptures can heal in sheep after both non-augmented and augmented ACL repair with free-functional rehabilitation. However, augmented repair leads to significantly better stability of the knee joint compared to transected controls and better limits the development of degenerative changes.