BACKGROUND: The anterior cruciate ligament (ACL) fails to heal after traumatic rupture. Furthermore, large-animal models have recently shown that 1-month functional ACL healing is augmented after suture repair when a bioactive scaffold is placed in the tear site. HYPOTHESIS: At the time of suture repair, placement of a bioactive scaffold in the ACL wound site would improve the structural properties of the tissue. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty-seven knees in immature pigs underwent ACL transection and suture repair. A collagen-platelet composite (CPC) was used to supplement the repair in 14 knees. Knees were harvested at 4 weeks, 6 weeks, and 3 months. Mechanical testing and histologic analysis were performed. RESULTS: The addition of a CPC to a suture repair resulted in improvements in yield load and linear stiffness of the repair tissue at 3 months, as well as a significant increase in cell density. A reduction in yield load and stiffness occurred at the 6-week time point in both groups, a phase when revascularization was noted. CONCLUSION: The addition of a CPC to a suture repair enhanced the structural properties of the ACL, and the improvement was associated with increased cellularity within the healing ligament. CLINICAL RELEVANCE: The addition of a bioactive scaffold to the wound site improved the functional healing of the ACL after suture repair. The decreased repair strength during revascularization may indicate a need to protect the repair site through this period.
BACKGROUND: The anterior cruciate ligament (ACL) fails to heal after traumatic rupture. Furthermore, large-animal models have recently shown that 1-month functional ACL healing is augmented after suture repair when a bioactive scaffold is placed in the tear site. HYPOTHESIS: At the time of suture repair, placement of a bioactive scaffold in the ACL wound site would improve the structural properties of the tissue. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty-seven knees in immature pigs underwent ACL transection and suture repair. A collagen-platelet composite (CPC) was used to supplement the repair in 14 knees. Knees were harvested at 4 weeks, 6 weeks, and 3 months. Mechanical testing and histologic analysis were performed. RESULTS: The addition of a CPC to a suture repair resulted in improvements in yield load and linear stiffness of the repair tissue at 3 months, as well as a significant increase in cell density. A reduction in yield load and stiffness occurred at the 6-week time point in both groups, a phase when revascularization was noted. CONCLUSION: The addition of a CPC to a suture repair enhanced the structural properties of the ACL, and the improvement was associated with increased cellularity within the healing ligament. CLINICAL RELEVANCE: The addition of a bioactive scaffold to the wound site improved the functional healing of the ACL after suture repair. The decreased repair strength during revascularization may indicate a need to protect the repair site through this period.
Authors: Martha M Murray; Elise M Magarian; Sophia L Harrison; Ashley N Mastrangelo; David Zurakowski; Braden C Fleming Journal: J Bone Joint Surg Am Date: 2010-09-01 Impact factor: 5.284
Authors: Daniel Hensler; Kenneth D Illingworth; Volker Musahl; Zachary M Working; Tetsuo Kobayashi; Motoko Miyawaki; Stephan Lorenz; Michelle Witt; James J Irrgang; Johnny Huard; Freddie H Fu Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-10-19 Impact factor: 4.342
Authors: Braden C Fleming; Benedikt L Proffen; Patrick Vavken; Matthew R Shalvoy; Jason T Machan; Martha M Murray Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-03-18 Impact factor: 4.342
Authors: Patrick Vavken; Braden C Fleming; Ashley N Mastrangelo; Jason T Machan; Martha M Murray Journal: Arthroscopy Date: 2012-01-20 Impact factor: 4.772
Authors: Braden C Fleming; Elise M Magarian; Sophia L Harrison; David J Paller; Martha M Murray Journal: J Orthop Res Date: 2010-06 Impact factor: 3.494