Repair of Knee Ligaments in Dogs

O’Donoghue, Daniel L.; Rockwood, Charles A.; Zaricznyj, B; Kenyon, Rex

doi:10.2106/00004623-196143080-00008

Cited by 40 publications

(1 citation statement)

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“…In a dog model, O’Donoghue et al [42] reported that surgical treatment led to a decrease in the amount of newly synthesized tissue and accelerated collagenisation in the healing process, thus improving morphological characteristics. Hart and Dahners [43] and Hildebrand and Frank [44] found no statistically significant difference in improved endurance of the MCL between nonoperative treatment and treatment by suturing.…”

Section: Introductionmentioning

confidence: 99%

The novel epiligament theory: differences in healing failure between the medial collateral and anterior cruciate ligaments

et al. 2022

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According to current literature, 90% of knee ligament injuries involve the medial collateral ligament or the anterior cruciate ligament. In contrast to the medial collateral ligament, which regenerates relatively well, the anterior cruciate ligament demonstrates compromised healing. In the past, there were numerous studies in animal models that examined the healing process of these ligaments, and different explanations were established. Although the healing of these ligaments has been largely investigated and different theories exist, unanswered questions persist.Therefore, the aim of this article is 1) to review the different historical aspects of healing of the medial collateral ligament and present the theories for healing failure of the anterior cruciate ligament; 2) to examine the novel epiligament theory explaining the medial collateral ligament healing process and failure of anterior cruciate ligament healing; and 3) to discuss why the enveloping tissue microstructure of the aforementioned ligaments needs to be examined in future studies.We believe that knowledge of the novel epiligament theory will lead to a better understanding of the normal healing process for implementing optimal treatments, as well as a more holistic explanation for anterior cruciate ligament healing failure.

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Section: Introductionmentioning

confidence: 99%

The novel epiligament theory: differences in healing failure between the medial collateral and anterior cruciate ligaments

et al. 2022

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Natural history of healing in the repaired medial collateral ligament

Frank

Schachar

Dittrich

1983

Journal Orthopaedic Research

106

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The purpose of this study was to assess morphologically the healing of repaired medial collateral ligaments (MCLs) in a rabbit model. Healing ligaments were examined grossly and histologically at various intervals, from 3 days to 2 1/2 years after injury, and compared with the appearances of normal age-, sex-, and activity-matched controls. Results show that all ligaments healed by bridging scar formation rather than true ligament regeneration. Increases in cellularity and temporary matrix disorganization along the entire length of the ligaments during healing suggest a combination of diffuse mechanical damage from their failure in tension and regional inflammatory injury (in excess of surgical exposure alone) from the processes of degradation and replacement. Substance that was not injured physically in this model demonstrated complete recovery, while that replaced by scar did not. Healing processes were similar to those of other highly specialized soft tissues (e.g., tendons), with short phases of hemorrhage and inflammation, an intermediate phase of proliferation, and a prolonged phase of remodeling. Failure of repairs to maintain anatomical apposition of torn ends may have contributed to the delay of these healing processes by increasing scar mass. Incomplete scar remodeling at 2 1/2 years, however, suggests much slower MCL healing than previously reported and probably, therefore, a longer period for potential treatment influence.

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Tendons and ligaments: A morphological and biochemical comparison

Amiel

Frank

Harwood

et al. 1983

Journal Orthopaedic Research

521

276

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The purpose of this study was to compare selected rabbit tendons and ligaments morphologically and biochemically. Five representative structures from each of six age-and sex-matched rabbits were compared. Biochemical analyses included total collagen, reducible collagen cross-links, quantitative collagen typing, DNA, and glycosaminoglycans. Histological and chemical differences were demonstrated between the tendons and the ligaments. Smaller differences were also found between the individual ligaments (collateral and cruciate) and between the two tendons (patellar and Achilles) that were examined. These findings suggest that ligaments are more metabolically active than tendons, having more plump cellular nuclei, higher DNA content, larger amounts of reducible cross-links, and the presence of more type I11 collagen, as compared with tendons. They also contain slightly less total collagen than tendons and more glycosaminoglycans. We conclude that the tendons and ligaments studied have unique histological and biochemical characteristics, despite their gross similarities. Relatively increased metabolic activity in ligaments, implied by our findings, may be species specific, age related (transient), or may truly represent a structural expression of functional need for more rapid adaptation. Further investigation of other similarities or differences between particular ligaments (or tendons) is indicated, and attention is directed toward the importance of such variables in development of models for tendon and ligament studies. Key Words: Tendon-Ligament-DNA concentration-Collagen cross-linking-Glycosaminoglycans-Comparison.Chronic knee ligament instabilities are most commonly treated by functional replacement with other periarticular structures, mainly tendons. These replacements have included the use of various parts of the quadriceps tendon mechanism (1 1,20,28), pes anserinus (39), semitendinosis tendon (8,36), biceps femoris tendon (38), gracilis tendon (43), iliotibial bank (17,31,34), and lengths of fascia lata twisted or rolled into tendonlike forms (24,25).

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Repair of Knee Ligaments in Dogs

Cited by 40 publications

References 0 publications

The novel epiligament theory: differences in healing failure between the medial collateral and anterior cruciate ligaments

The novel epiligament theory: differences in healing failure between the medial collateral and anterior cruciate ligaments

Natural history of healing in the repaired medial collateral ligament

Tendons and ligaments: A morphological and biochemical comparison

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