The Effect of Skeletal Maturity on Functional Healing of the Anterior Cruciate Ligament

Murray, Martha M.; Magarian, Elise M.; Harrison, Sophia L.; Mastrangelo, Ashley N.; Zurakowski, David; Fleming, Braden C.

doi:10.2106/jbjs.i.01368

Cited by 94 publications

(141 citation statements)

References 24 publications

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“…In our experience, anterior cruciate ligament (ACL) transection in the mini pig, with or without reconstruction, has provided a useful model for the study of OA changes in a large animal model (7). The anatomy of the pig knee is similar enough to human anatomy to allow for the study of surgical interventions including arthroscopy, cartilage resurfacing, and ACL reconstruction (8)(9)(10)(11). Mini pigs reach skeletal maturity at 18-24 months (8).…”

Section: Common Animal Modelsmentioning

confidence: 99%

“…The anatomy of the pig knee is similar enough to human anatomy to allow for the study of surgical interventions including arthroscopy, cartilage resurfacing, and ACL reconstruction (8)(9)(10)(11). Mini pigs reach skeletal maturity at 18-24 months (8). The mini pig is preferred because the smaller size allows easier handling of the animals and avoids the rapid growth phase of other domestic pig breeds.…”

Section: Common Animal Modelsmentioning

confidence: 99%

See 1 more Smart Citation

Animal Models of Osteoarthritis: Challenges of Model Selection and Analysis

Teeple

Jay

Elsaid

et al. 2013

AAPS J

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175

192

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ABSTRACT. Osteoarthritis (OA) is the most common musculoskeletal disease, affecting millions of individuals worldwide. New treatment approaches require an understanding of the pathophysiology of OA and its biomechanical, inflammatory, genetic, and environmental risk factors. The purpose of animal models of OA is to reproduce the pattern and progression of degenerative damage in a controlled fashion, so that opportunities to monitor and modulate symptoms and disease progression can be identified and new therapies developed. This review discusses the features, strengths, and weaknesses of the common animal models of OA; considerations to be taken when choosing a method for experimental induction of joint degeneration; and the challenges of measuring of OA progression and symptoms in these models.

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Section: Common Animal Modelsmentioning

confidence: 99%

Section: Common Animal Modelsmentioning

confidence: 99%

Animal Models of Osteoarthritis: Challenges of Model Selection and Analysis

Teeple

Jay

Elsaid

et al. 2013

AAPS J

Self Cite

175

192

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“…Although abandoned in the past, there is renewed interest in the primary healing capacity of this ligament [24][25][26][27]. In younger people in particular, ACL ruptures often occur at the femoral attachment of the ligament [28,29].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study

Seitz

Pichl

Matzi

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate in a sheep model the biomechanical performance of augmented and nonaugmented primary repair of the anterior cruciate ligament (ACL) following transection at the femoral end during a 12-month postoperative observation. Methods Forty sheep were randomly assigned to nonaugmented or augmented primary ACL repair using a polyethylene terephthalate (PET) band. At two, six, 16, 26 and 52 weeks postoperatively four sheep in each group were sacrificed and biomechanical testing performed. Results Compared with nonaugmented primary ACL repair, the PET-augmented repair demonstrated superior biomechanical results from 16 weeks postoperatively onwards in terms of anterioposterior (AP) laxity, tensile strength and ligament stiffness. The augmentation device works as a stress shield during the ligament healing process. The nonaugmented ACL repair also resulted in ligament healing, but the biomechanical properties were at a significantly lower level. Conclusion These results support the previously reported histological findings following augmented primary ACL repair. This animal study on the healing capacity of the ACL may provide some important contributions to how primary healing in certain types of ruptures can be achieved.

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“…They also attempted to add provisional scaffold by use of surgical suture through the injured ACL [31][32][33][34]. These studies have concluded the biomechanical features of healed ACL following the use of "bioenhanced" ACL repair techniques were equivalent to that of conventional ACL reconstruction [33]. These results confirmed that the lack of scaffold between the two ends of the injured ACL was a key mechanism behind its failure to spontaneously heal.…”

Section: Key Player In Acl Spontaneous Healing?mentioning

confidence: 82%

“…Treatment of ACL injuries with collagen-PRP hydrogel resulted in increased filling of the wound site with repair tissue that had similar profiles of growth factors and protein expression as in extra-articular ligament injuries [30]. They also attempted to add provisional scaffold by use of surgical suture through the injured ACL [31][32][33][34]. These studies have concluded the biomechanical features of healed ACL following the use of "bioenhanced" ACL repair techniques were equivalent to that of conventional ACL reconstruction [33].…”

Section: Key Player In Acl Spontaneous Healing?mentioning

confidence: 99%

Key Determinants of Anterior Cruciate Ligament Spontaneous Healing

Kokubun¹,

Kanemura²,

Murata³

et al. 2017

J Osteopor Phys Act

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Anterior cruciate ligament (ACL) injuries are known to have very low rates of spontaneous healing. There have been several studies since the mid-1960s concerning the approaches to accelerate spontaneous healing of ACL injuries. Recent studies have identified similarities in the healing response of ACL and other extra-articular ligaments, in terms of their cellular response and vascularity. Research has demonstrated that mechanical stress has an important influence on the biological response of tissue healing. Novel treatment approaches may exploit the role of mechanical loads on the regulation of gene expression in achieving spontaneous healing of injured ACL. This article reviews the determinants of the ACL healing response and their relationship to mechanical stress and spontaneous healing, and explores novel concepts that are emerging in the management of ACL injuries. Keywords Current Treatment for ACL injuriesThe anterior cruciate ligament (ACL) plays an important role in motion at the knee joint and therefore, in the related physical activities of daily living. The ACL stabilizes the knee and guides the movement of the tibia and femur at the joint. Injuries involving the ACL are well known for hopeless of spontaneous healing. Several studies have investigated the mechanisms of low healing response and the approaches to accelerating spontaneous healing of ACL injuries, since the mid-1960s [1][2][3][4]. The reasons for the failure of the ACL to heal spontaneously are related to specific intra-articular features [5,6] as well as owing to various molecular biological characteristics [7,8]. A number of studies have addressed on explaining the reasons for the failure of the ACL to heal spontaneously [1,3,[9][10][11][12][13]. Since ACL injuries contribute to an increased risk of knee osteoarthritis [14,15], the current gold standard for the management of complete ACL rupture is reconstruction using a tendon autograft. However, there are no highquality randomized controlled trials comparing ACL reconstruction with other modalities of treatment [16][17][18][19].However, it is clear that the spontaneous healing capacity of the ACL has been underestimated. Several clinical studies have reported results of ACL healing with non-surgical treatment alone [20][21][22]. Moreover, an organ culture model of the human ACL showed a high intrinsic healing capacity [23]. Although these studies have demonstrated that the human ACL remnant has functional healing capacities, this was not proved in rigorous scientific methods. Consequently, current non-surgical treatment for ACL injuries aims at rehabilitating patients to modify the patients' physical activities to continue their dairy living, but not to support their spontaneous healing of the injured ACL [24,25]. This comprises muscle strength exercises, range of motion exercises, neuro-muscular training, and bracing. To summarize, although surgical reconstruction with autograft is considered to be the standard of care for restoring knee function following complete ACL in...

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The Effect of Skeletal Maturity on Functional Healing of the Anterior Cruciate Ligament

Cited by 94 publications

References 24 publications

Animal Models of Osteoarthritis: Challenges of Model Selection and Analysis

Animal Models of Osteoarthritis: Challenges of Model Selection and Analysis

Biomechanical evaluation of augmented and nonaugmented primary repair of the anterior cruciate ligament: an in vivo animal study

Key Determinants of Anterior Cruciate Ligament Spontaneous Healing

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