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Allograft ligament transplantation

A morphological and biochemical evaluation of a medial collateral ligament complex in a rabbit model

Joint Injury and Diseases Research Group, Faculty of Medicine

CY Frank, MD

Joint Injury and Diseases Research Group, Faculty of Medicine, Department of Surgery, Division of Orthopaedics

Tack Lam, PhD

Faculty of Engineering, Department of Civil Engineering, The University of Calgary, Calgary, Alberta, Canada

Nigel Shrïve, DPhil

Joint Injury and Diseases Research Group, Faculty of Medicine, Faculty of Engineering, Department of Civil Engineering, The University of Calgary, Calgary, Alberta, Canada

Our purpose in this investigation was to describe and compare several morphological, histological, vascular, and biochemical healing processes of allograft and autograft bone-medial collateral ligament-bone com plexes in a rabbit model. Forty-nine animals had their right medial collateral ligament complex replaced with a frozen allograft while 30 separate control animals each received a fresh autograft. Animals were sacrificed at 3, 6, 12, 24, or 48 weeks after transplantation for comparison of grafted with unoperated contralateral control complexes. Results demonstrate some recov ery of both allografts and autografts over time. Allo grafts generally showed slower recovery than auto grafts with more persistent abnormalities in gross ap pearances, increased cellularity (corresponding to increased DNA content), and decreased collagen con tent. Allografts also showed aggressive remodeling of bone at insertions and they remained hypervascular throughout their substance as compared with contra lateral controls. Autografts went through similar but less chronic increases in cellularity and DNA concentra tion with no changes in collagen content. While both types of grafts showed some signs of "healing" and some recovery of control ligament biology, results are also consistent with allograft encasement, infiltration, and at least partial replacement by host tissue. This was particularly true of insertions. Collectively, these results also demonstrate some differences between allografts and autografts in this extraarticular model. The causes, mechanisms, and longer-term conse quences of these changes, including defining the qual ities of these graft and host tissues, clearly requires further investigation.