Treatment of the medial collateral ligament injury, II:​ structure and function of canine knees in response to differing treatment regimens

Woo, Savio L.-Y.<sup>1</sup>; Inoue, Masahiro<sup>1</sup>; McGurk-Burleson, Erin<sup>1</sup>; Gomez, Mark A.<sup>1</sup>

Affiliations

¹Orthopaedic Bioengineering Laboratory, San Diego Veterans Administration Medical Center, Malcolm and Dorothy Coutts Institute for Joint Reconstruction and Research, and the University of California, San Diego, LaJolla, California

Abstract

In order to assess the healing of the medial collateral ligament (MCL) and to detect the various effects of treatment regimens, in vivo animal experiments using a canine model were performed. Thirty-five canine MCLs were surgically transected and treated using three clinically popular regimens, e.g., no repair with cage and farm activities (Group 1), repair with 3 weeks immobilization (Group 2), and repair with 6 weeks im mobilization (Group 3). The varus-valgus laxity of the knee joint, structural properties of the femur-MCL-tibia (FMT) complex and the mechanical properties of the MCL substance (healing site) were quantitatively meas ured at 6, 12, and 48 weeks postoperatively. It was found that Group 1 animals had the best results. The varus-valgus laxity of the knee joint and the structural properties of the FMT complex returned to values comparable with the contralateral control by 12 weeks. The recovery of the mechanical properties of the MCL substance was slower and not complete, even at 48 weeks. In confirmation with previous studies, prolonged immobilization was shown to have deleterious effects on MCL healing. The results of this study indicated that early mobilization is the treatment of choice in cases of isolated MCL injury. Also, this study emphasized the importance and effectiveness of using various biome chanical parameters in addition to the conventional ultimate values at failure to evaluate the progress of soft tissue repair.

Links

DOI: 10.1177/03635465870150010

PubMed: 3812858

WoS: A1987F856600004

Cited Works (5)

Year	Entry
1986	Woo SL, Orlando CA, Gomez MA, Frank CB, Akeson WH. Tensile properties of the medial collateral ligament as a function of age. J Orthop Res. 1986;4(2):133-141.
1976	Woo SL-Y, Akeson WH, Jemmott GF. Measurements of nonhomogeneous, directional mechanical properties of articular cartilage in tension. J Biomech. 1976;9(12):785-791.
1982	Woo SL-Y. Mechanical properties of tendons and ligaments, I: quasi-static and nonlinear viscoelastic properties. Biorheology. 1982;19(3):385-396.
1983	Woo SL-Y, Gomez MA, Seguchi Y, Endo CM, Akeson WH. Measurement of mechanical properties of ligament substance from a bone-ligament-bone preparation. J Orthop Res. 1983;1(1):22-29.
1982	Woo SL-Y, Gomez MA, Woo Y-K, Akeson WH. Mechanical properties of tendons and ligaments, II: the relationships of immobilization and exercise on tissue remodeling. Biorheology. 1982;19(3):397-408.

Cited By (20)

Year	Entry
1992	Woo SL-Y, Ohland KJ, Fu FH. Healing and repair of knee ligaments relating to sports injury. In: Proceedings of the 2nd Injury Prevention Through Biomechanics Symposium. April 10-11, 1992; Detroit, MI.3-6.
2003	Woo SL-Y, Abramowitch SD, Loh JC, Musahl V, Wang JH-C. Ligament healing: present status and the future of functional tissue engineering. In: Guilak F, Butler DL, Goldstein SA, Mooney DJ, eds. Functional Tissue Engineering. New York, NY: Inc., Springer-Verlag; 2003:17-34.
2000	Woo SL-Y, Debski RE, Zeminski J, Abramowitch SD, Chan Saw SS, Fenwick JA. Injury and repair of ligaments and tendons. Annu Rev Biomed Eng. 2000;2:83-118.
1997	Renström PAFH, Konradsen L. Ankle ligament injuries. Br J Sports Med. March 1997;31(1):11-20.
1991	Weiss JA, Woo SL-Y, Ohland KJ, Horibe S, Newton PO. Evaluation of a new injury model to study medial collateral ligament healing: primary repair versus nonoperative treatment. J Orthop Res. July 1991;9(4):516-528.
2001	Wang VM-W. Biomechanics of the Normal and Surgically Reconstructed Shoulder [PhD thesis]. Columbia University; 2001.
2010	Loghmani MT. The Effects of Instrument-Assisted Cross Fiber Massage on Ligament Healing [PhD thesis]. Indianapolis, IN: Indiana University; May 2010.
1996	Levine RE. Heterogeneity of the Medial Collateral Ligament in Uniaxial Tension [PhD thesis]. University of Pittsburgh; 1996.
2004	Abramowitch SD. An Evaluation of the Non-Linear Viscoelastic Properties of the Healing Medial Collateral Ligament [PhD thesis]. University of Pittsburgh; 2004.
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2010	Fisher MB. Functional Tissue Engineering of the Healing Anterior Cruciate Ligament: A Combined Experimental and Computational Approach [PhD thesis]. University of Pittsburgh; 2010.
2015	Farraro KF. Regeneration of the Anterior Cruciate Ligament Using Resorbable Metallic and Extracellular Matrix Bioscaffolds [PhD thesis]. University of Pittsburgh; 2015.
1999	Awad HA. Mesenchymal Stem Cell Seeded Collagen Scaffolds for Tendon Repair [PhD thesis]. University of Cincinnati; 1999.
1988	Bahlsen A. The Etiology of Running Industries: A Longitudinal, Prospective Study [PhD thesis]. Calgary, AB: University of Calgary; December 1988.
2004	Lin TW. Development and Utilization of a Transgenic Mouse Injury Model to Investigate the Role of Interleukin-4 and Interleukin-6 in Tendon Healing [PhD thesis]. Philadelphia, PA: University of Pennsylvania; 2004.
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2002	Mkandawire C. The Relationship Between Viscoelastic Relaxation and Ligament Morphometry [PhD thesis]. Seattle, WA: University of Washington; 2002.
1997	Hurschler C. Collagen Matrix in Normal and Healing Ligaments: Microstructural Behavior, Biological Adaptation, and a Structural Mechanical Model [PhD thesis]. University of Wisconsin – Madison; 1997.
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