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Cited by 300Tendon Structure and TreatmentPeriodontal Regeneration and TreatmentsKnee injuries and reconstruction techniques

Enhanced histologic repair in a central wound in the anterior cruciate ligament with a collagen–platelet‐rich plasma scaffold

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Murray, Martha M., Spindler, Kurt P., Ballard, Percy, Welch, Tyler P., Zurakowski, David, Nanney, Lillian B.·2007·Journal of Orthopaedic Research
DOI 10.1002/jor.20367
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Abstract

The anterior cruciate ligament (ACL) of the knee is an intra‐articular ligament that fails to heal after primary repair. The medial collateral ligament (MCL) of the knee is an extra‐articular ligament that heals uneventfully in the majority of cases. Why these two ligaments have such different responses to injury remains unclear. In this article, we address two hypotheses: first, that the histologic response to injury is different in intra‐articular and extra‐articular ligaments, and second, that the response of the intra‐articular ligaments can be altered by placing a collagen–platelet‐rich plasma (collagen‐PRP) hydrogel in the wound site. Wounds were created in extra‐articular ligaments (MCL and/or patellar ligament) and an intra‐articular ligament (ACL) in canine knees, and the histologic response to injury evaluated at 3 days (n = 3), 7 days (n = 4), 3 weeks (n = 5), and 6 weeks (n = 5). In the 3‐week (n = 5) and 6‐week (n = 5) animals, bilateral central wounds were made in the ACLs and the wounds in one knee of each animal treated with a collagen‐PRP hydrogel while the contralateral side was untreated. Extra‐articular ligament wounds had greater filling of the wound site and increased presence in the wound site of fibrinogen, fibronectin, PDGF‐A, TGF‐β1, FGF‐2, and von Willebrand's factor when compared to intra‐articular ligament wounds. Treatment of the intra‐articular wound with a collagen‐PRP hydrogel resulted in increased filling of the wound site with repair tissue that had similar profiles of growth factor and protein expression to the extra‐articular ligament wounds. The use of a collagen‐PRP scaffold can ameliorate histologic differences noted between healing extra‐articular ligamentous wounds and nonhealing intra‐articular ligamentous wounds. This study supports the hypothesis that premature scaffold failure may play a key role in the normally expected failure of the ACL to heal after injury. Published by Wiley Periodicals, Inc. J Orthop Res 25:1007–1017, 2007

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Authors
Murray, M. M., Spindler, K. P., Ballard, P., Welch, T. P., Zurakowski, D., & Nanney, L. B.
Affiliations
  • Boston Children's Hospital (US)
  • Vanderbilt University (US)
Corresponding author
Murray, Martha M.
ORCID
Venue
Journal of Orthopaedic Research
Publisher
Wiley
Published
2007-04-05
Volume
25
Issue
8
Pages
1007-1017
ISSN
  • 0736-0266 (ISSN-L)
  • 1554-527X
DOI
10.1002/jor.20367
OpenAlex
W2051763141
Cited by
300
References
28
Citations by year
2026: 4 · 2025: 6 · 2024: 9 · 2023: 10 · 2022: 13 · 2021: 20 · 2020: 10 · 2019: 9 · 2018: 10 · 2017: 23 · 2016: 17 · 2015: 25 · 2014: 18 · 2013: 35 · 2012: 17
FWCI
18.37
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Orthopaedic Research® (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Vanderbilt University
  • Vanderbilt University Medical Center
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (K02AR049346)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
  • Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
Keywords
anterior cruciate ligament, ligament healing, scaffolds, medial collateral ligament, patellar tendon, wound healing, growth factors, fibrinogen, fibronectin, PDGF-A, TGF-β1, FGF2, von Willebrand factor, canine model
MeSH terms
Anterior Cruciate Ligament Injuries, Animals, Collagen, Dogs, Knee Injuries, Wound Healing, Anterior Cruciate Ligament, Medial Collateral Ligament, Knee, Hydrogels, Platelet-Rich Plasma

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