Collagen‐platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament

Abstract

ABSTRACT:The anterior cruciate ligament (ACL) fails to heal after suture repair. One hypothesis for this failure is the premature loss of the fibrin clot, or provisional scaffolding, between the two ligament ends in the joint environment. To test this hypothesis, a substitute provisional scaffold of collagen-platelet rich plasma (PRP) hydrogel was used to fill the ACL wound site at the time of suture repair and the structural properties of the healing ACLs evaluated 4 weeks after surgery. Bilateral ACL transections were performed in five 30-kg Yorkshire pigs and treated with suture repair. In each animal, one of the repairs was augmented with placement of a collagen-PRP hydrogel at the ACL transection site, while the contralateral knee had suture repair alone. In addition, six control knees with intact ACLs from three additional animals were used as a control group. No postoperative immobilization was used. After 4 weeks the animals underwent in vivo magnetic resonance imaging to assess the size of the healing ACL, followed by biomechanical testing to determine tensile properties. The supplementation of suture repair with a collagen-PRP hydrogel resulted in significant improvements in load at yield, maximum load, and linear stiffness at 4 weeks. We conclude that use of a stabilized provisional scaffold, such as a collagen-PRP hydrogel, to supplement primary repair of the ACL can result in improved biomechanical properties at an early time point. Further studies to determine the long-term effect of primary repair enhancement are needed. ß

Healing of the Goat Anterior Cruciate Ligament After a New Suture Repair Technique and Bioscaffold Treatment

“…Compared to recent research that focused on suture repair of the ACL in combination with platelet-rich plasma delivery and scaffolds, [36][37][38][39] the results in the current study are not far off in terms of the functional outcomes. The total AP translation of the repaired ACL was 290% to 440% of the intact control under 67N anterior and posterior tibial load (AP load).…”

2011 AOA Symposium: Tissue Engineering and Tissue Regeneration

“…A suture repair was performed and then a collagen-platelet scaffold was placed in the gap between the two severed ends of the ligament (a technique called the bio-enhanced suture repair). Using this model, we found that placement of a collagen-platelet scaffold in the wound site of the ACL could stimulate both histologic and biomechanical healing of the ligament 76 and that, by three months, the strength of the ACL treated with a bio-enhanced repair technique was similar to that previously reported for ACL reconstruction in similar animal models 77 . Interestingly enough, when either a collagen scaffold alone 78 or a platelet solution alone 79 was used as the bio-enhancement, there was no statistically significant improvement over suture repair alone.…”

Validation of Porcine Knee as a Sex-specific Model to Study Human Anterior Cruciate Ligament Disorders

“…Large animal models including pigs, sheep, goats, dogs, and rabbits have been used as surrogates to study the effects of surgical intervention after ACL injury [7,17,19,20,22,26,44]. Among those, the porcine model has been shown to be the closest to the human based on the size and anatomy of the knee [48], functional dependence on the ACL [10], gait biomechanics [60], and similarity of hematology and wound healing characteristics [15,38,40]. However, it is unknown if the porcine model also could be used to study sex-related phenomena associated with ACL injury.…”