Treatment with bioscaffold enhances the the fibril morphology and the collagen composition of healing medial collateral ligament in rabbits.

Porcine small intestinal submucosa (SIS) was shown to be an effective bioscaffold in enhancing the mechanical properties of healing medial collateral ligaments (MCL). The purpose of this study was to investigate whether there are corresponding improvements in morphology and tissue compositions. Fourteen rabbits were equally divided into two groups. In the SIS-treated group, a 6 mm gap was surgically created in the right MCL and a layer of SIS was sutured covering the gap. For the nontreated group, the gap-injured MCLs remained untreated. All the left MCLs were sham operated and used as controls. At 12 weeks, the status of collagen types I and V was evaluated with immunofluorescent staining. The collagen type V/I ratios were obtained using SDS-PAGE. Collagen fibril diameters were calculated from the transmission electron micrographs. The results revealed that in the SIS-treated group, the collagen fibers were more regularly aligned as were the cell nuclei. The collagen fibril diameters were 22.2% larger and the ratio of collagen type V/I was 28.4% lower than those for the nontreated group (p < 0.05). These improvements in the morphological characteristics and biochemical constituents of healing MCLs following SIS treatment are the likely reasons for improved mechanical properties.

[1]  D A Parry,et al.  A comparison of the size distribution of collagen fibrils in connective tissues as a function of age and a possible relation between fibril size distribution and mechanical properties , 1978, Proceedings of the Royal Society of London. Series B. Biological Sciences.

[2]  J. R. Parsons,et al.  Medial collateral ligament replacement with a partially absorbable tissue scaffold , 1983, The American journal of sports medicine.

[3]  D. Birk,et al.  Collagen type I and type V are present in the same fibril in the avian corneal stroma , 1988, The Journal of cell biology.

[4]  D A Parry,et al.  The molecular and fibrillar structure of collagen and its relationship to the mechanical properties of connective tissue. , 1988, Biophysical chemistry.

[5]  R. Rangayyan,et al.  Electron microscopic quantification of collagen fibril diameters in the rabbit medial collateral ligament: a baseline for comparison. , 1989, Connective tissue research.

[6]  S. Woo,et al.  Medical collateral ligament healing subsequent to different treatment regimens. , 1989, Journal of applied physiology.

[7]  S. Woo,et al.  Effects of surgical treatment and immobilization on the healing of the medial collateral ligament: a long-term multidisciplinary study. , 1990, Connective tissue research.

[8]  K. Doane,et al.  Collagen fibrillogenesis in vitro: interaction of types I and V collagen regulates fibril diameter. , 1990, Journal of cell science.

[9]  S L Woo,et al.  Evaluation of a new injury model to study medial collateral ligament healing: Primary repair versus nonoperative treatment , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[10]  R Rangayyan,et al.  Collagen fibril diameters in the healing adult rabbit medial collateral ligament. , 1992, Connective tissue research.

[11]  D. Birk,et al.  Type V collagen: molecular structure and fibrillar organization of the chicken alpha 1(V) NH2-terminal domain, a putative regulator of corneal fibrillogenesis , 1993, The Journal of cell biology.

[12]  S. Badylak,et al.  The use of xenogeneic small intestinal submucosa as a biomaterial for Achilles tendon repair in a dog model. , 1995, Journal of biomedical materials research.

[13]  B. Reider.  Medial Collateral Ligament Injuries in Athletes , 1996, Sports medicine.

[14]  S. Woo,et al.  Medial collateral knee ligament healing. Combined medial collateral and anterior cruciate ligament injuries studied in rabbits. , 1997, Acta orthopaedica Scandinavica.

[15]  C. Frank,et al.  Collagen fibril diameters in the rabbit medial collateral ligament scar: a longer term assessment. , 1997, Connective tissue research.

[16]  S L Woo,et al.  The Effects of Platelet-Derived Growth Factor-BB on Healing of the Rabbit Medial Collateral Ligament , 1998, The American journal of sports medicine.

[17]  S. Woo,et al.  Tissue engineering of ligament and tendon healing. , 1999, Clinical orthopaedics and related research.

[18]  S. Badylak,et al.  Naturally occurring extracellular matrix as a scaffold for musculoskeletal repair. , 1999, Clinical orthopaedics and related research.

[19]  S. Arnoczky,et al.  Use of small intestinal submucosal implants for regeneration of large fascial defects: an experimental study in dogs. , 1999, Journal of biomedical materials research.

[20]  L L Marchuk,et al.  Decorin antisense gene therapy improves functional healing of early rabbit ligament scar with enhanced collagen fibrillogenesis in vivo , 2000, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[21]  Savio L-Y. Woo,et al.  Type V collagen is increased during rabbit medial collateral ligament healing , 2000, Knee Surgery, Sports Traumatology, Arthroscopy.

[22]  R. Haut,et al.  Tissue-Engineered Rotator Cuff Tendon Using Porcine Small Intestine Submucosa , 2001, The American journal of sports medicine.

[23]  D. Birk,et al.  Type V collagen: heterotypic type I/V collagen interactions in the regulation of fibril assembly. , 2001, Micron.

[24]  S. Woo,et al.  Fate of donor bone marrow cells in medial collateral ligament after simulated autologous transplantation , 2002, Microscopy research and technique.

[25]  Volker Musahl,et al.  The use of porcine small intestinal submucosa to enhance the healing of the medial collateral ligament—a functional tissue engineering study in rabbits , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[26]  R. Jakob,et al.  The non operative treatment of isolated complete tears of the medial collateral ligament of the knee , 1988, Archives of orthopaedic and traumatic surgery.