Healing ligament mechanical properties are improved by repair with interpositional allografts but not by concomitant treatment with hyaluronic acid.
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.
McCaig Institute for Bone and Joint Health, University of Calgary, 451A Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, Alberta, Canada. gail.thornton@ucalgary.ca
Gail M
GM
Thornton
Xinxin
X
Shao
Marielle E
ME
Kuchison
Linda L
LL
Marchuk
Nigel G
NG
Shrive
Cyril B
CB
Frank
D000818:Animals; D001696:Biomechanical Phenomena; D005260:Female; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007593:Joint Instability / Q000503:physiopathology; D007718:Knee Injuries / Q000601:surgery*; D017888:Medial Collateral Ligament, Knee / Q000293:injuries* / Q000502:physiology / Q000637:transplantation*; D011817:Rabbits; D014184:Transplantation, Homologous; D055675:Viscosupplements / Q000627:therapeutic use*
D055675:Viscosupplements; D006820:Hyaluronic Acid