title: Anterior crucial ligament rupture: self-healing through dynamic intraligamentary stabilization technique.
abstract: OBJECTIVE
  Surgery involving arthroscopic reconstruction of the injured ligament is the gold standard treatment for torn anterior cruciate ligament (ACL). Recent studies support the hypothesis of biological self-healing of ruptured ACL. The aim of the study is to evaluate, in an animal model, the efficacy of a new technique, dynamic intraligamentary stabilization that utilizes biological self-healing for repair of acute ACL ruptures.
  
  
  METHODS
  The ACL in 11 adult female white alpine sheep was transected and in 8 sheep reconstructed by dynamic intraligamentary stabilization. To enhance the healing potential, microfracturing and collagen were used in all animals. The contralateral, non-operated knees served as controls. At 3 months postkilling, all animals were submitted to magnetic resonance imaging and biomechanical and histological evaluation.
  
  
  RESULTS
  No surgery-related complications were observed. Postoperatively, all animals regularly used the operated leg with full weight bearing and no lameness. At the time of killing, all animals exhibited radiological and histological healing of the transacted ACL. Biomechanical tests confirmed successful restoration of anteroposterior translation in the dynamic intraligamentary stabilization knees. Histological examination revealed dense scar tissue at the ends of the transected ligaments exhibiting hypercellularity and hypervascularization.
  
  
  CONCLUSIONS
  The dynamic intraligamentary stabilization technique successfully induced self-healing of ruptured ACL in a sheep model. Knee joints remained stable during the healing period allowing free range of motion and full weight bearing, and no signs of osteoarthritis or other intraarticular damage in the follow up were observed.
authors.affiliation: Department of Orthopedic Surgery, Inselspital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland. Sandro.Kohl@Insel.ch
authors.forename: Sandro
authors.initials: S
authors.lastname: Kohl
authors.forename: Dimitrios S
authors.initials: DS
authors.lastname: Evangelopoulos
authors.forename: Hendrik
authors.initials: H
authors.lastname: Kohlhof
authors.forename: Max
authors.initials: M
authors.lastname: Hartel
authors.forename: Harald
authors.initials: H
authors.lastname: Bonel
authors.forename: Phillip
authors.initials: P
authors.lastname: Henle
authors.forename: Brigitte
authors.initials: B
authors.lastname: von Rechenberg
authors.forename: Stefan
authors.initials: S
authors.lastname: Eggli
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D054544:Arthroplasty, Subchondral; D004195:Disease Models, Animal; D005260:Female; D009984:Orthopedic Fixation Devices; D012075:Remission, Spontaneous; D012421:Rupture; D012756:Sheep; D014945:Wound Healing / Q000502:physiology*