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Creep Behavior of a Rabbit Model of Ligament Laxity after Electrothermal Shrinkage In Vivo

Andrew L. Wallace, MD, PhD, FRACS(Orth), Robert M. Hollinshead, MD, FRCSC and Cyril B. Frank, MD, FRCSC

McCaig Centre for Joint Injury and Arthritis Research, University of Calgary, Calgary, Alberta, Canada

Presented at the interim meeting of the AOSSM, Anaheim, California, February 1999.

Address correspondence and reprint requests to Andrew L. Wallace, MD, PhD, Department of Orthopaedic Surgery, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, United Kingdom

Deformation of capsular tissue under constant load (creep) may lead to recurrent laxity after thermal shrinkage for shoulder instability. We investigated the effects of thermal shrinkage in a rabbit model in which the tibial insertion of the medial collateral ligament was elevated and shifted toward the joint line to create abnormal laxity. On the right side, radiofrequency electrothermal energy was applied to the shifted ligament, while the left side served as a control. Length, laxity, mass, cross-sectional area, water content, and creep behavior of the ligament were assessed at 0 (N = 8), 3 (N = 7), and 12 (N = 6) weeks postoperatively. Laxity was reduced with thermal treatment (0.65 ± 0.31 compared with 3.33 ± 0.25 mm). After 3 weeks, ligament mass, area, and water content were significantly increased in the thermally treated group compared with the untreated controls. At 12 weeks, cyclic creep strain remained greater than that in controls (1.25% ± 0.65% compared with 0.93% ± 0.22%). Although thermal shrinkage reduced laxity, there was increased potential to creep and failure at low physiologic stresses. These findings suggest that loading of thermally treated tissues should be carefully controlled during the early phase of rehabilitation after surgery.

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