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Anterior cruciate ligament reconstruction using a composite collagenous prosthesis

A biomechanical and histologic study in rabbits

Orthopaedic Research Laboratory, Division of Orthopaedic Surgery, Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey

Alfred J. Tria, MD

Orthopaedic Research Laboratory, Division of Orthopaedic Surgery

Y. Pedro Kato, PhD

Biomaterials Center, Department of Pathology, University of Medicine

Jeffrey R. Bechler, MD

Orthopaedic Research Laboratory, Division of Orthopaedic Surgery

Robert S. Ochner, MD

Orthopaedic Research Laboratory, Division of Orthopaedic Surgery

Joseph P. Zawadsky, MD

Orthopaedic Research Laboratory, Division of Orthopaedic Surgery

Frederick H. Silver, PhD

Biomaterials Center, Department of Pathology, University of Medicine

We evaluated a prototype composite collagenous an terior cruciate ligament replacement device designed to possess the advantages of biological grafts and syn thetic materials. Collagenous anterior cruciate ligament prostheses were made by embedding 225 reconsti tuted type I collagen fibers in a type I collagen matrix, and placing polymethylmethacrylate bone fixation plugs on the ends. The collagenous prosthesis was used to replace the anterior cruciate ligament of 31 mature rabbits. At 4 and 20 weeks postimplantation, histologic and mechanical studies were performed on the devel oping neoligament tissue, and compared to values for the contralateral sham-operated control.

At 4 weeks, neoligament tissue infiltrated the collagen fibers of the prostheses. The tibial bone tunnel attach ment site contained new bone approaching the fibrous neoligament. The glutaraldehyde-treated prosthetic fi bers appeared intact, while the carbodiimide-treated prosthetic fibers began to resorb. The ultimate load and ultimate tensile strength of femur-neoligament-tibia complexes had decreased.

At 20 weeks, glutaraldehyde-treated fibers appeared partially intact; in contrast, the carbodiimide-treated prostheses appeared to be completely degraded, and were replaced by organized, crimped neoligament tis sue. The ultimate tensile strength and ultimate load increased substantially due to deposition and remod eling of neoligament tissue. The neoligament ultimate load was 2 to 4 times the initial load value of the prosthesis.

Implantation of a resorbable, composite collagenous anterior cruciate ligament prosthesis encourages the development of functional neoligament tissue. Studies are underway to optimize the mechanical and biological properties of the prostheses.

This article has been cited by other articles:

				J. A. Cooper Jr., J. S. Sahota, W. J. Gorum II, J. Carter, S. B. Doty, and C. T. Laurencin Biomimetic tissue-engineered anterior cruciate ligament replacement PNAS, February 27, 2007; 104(9): 3049 - 3054. [Abstract] [Full Text] [PDF]