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Healing ligament mechanical properties are improved by repair with interpositional allografts but not by concomitant treatment with hyaluronic acid
Author(s) -
Thornton Gail M.,
Shao Xinxin,
Kuchison Marielle E.,
Marchuk Linda L.,
Shrive Nigel G.,
Frank Cyril B.
Publication year - 2009
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20776
Subject(s) - medicine , scars , hyaluronic acid , hindlimb , medial collateral ligament , ligament , surgery , in vivo , anatomy , microbiology and biotechnology , biology
Healing ligaments have inferior mechanical properties compared to normal ligaments during early healing intervals. The purpose of this study was to investigate if in vivo ligament repair with an interpositional allograft and treatment with hyaluronic acid (HA) would improve the mechanical properties of a medial collateral ligament (MCL) healing from a gap injury. Twenty rabbits were assigned equally to either a donor or recipient group. A gap injury of the MCL was created in both hindlimbs of 10 recipient animals. The right hindlimb was treated with allograft plus HA while the left hindlimb was treated with allograft only. Low‐load and high‐load mechanical properties, including laxity, relaxation and failure, and histology were evaluated after 6 weeks of healing. Mechanical results were compared to previously published normal MCL and MCL gap scar data. MCL allografts had greater initial force during cyclic relaxation testing and maximum force during failure testing than MCL scars, but were weaker than normal MCLs. Failure stress was the only parameter to demonstrate a statistically significant effect of treatment with HA on the allografts. However, the failure stress of the HA‐treated MCL allografts was not different than MCL scars and was less than normal MCLs. In conclusion, interpositional allografts could enhance some mechanical properties of ligament healing but HA, in the way we applied it, did not produce an obvious improvement. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:400–407, 2009