Collagen-platelet composite enhances biomechanical and histologic healing of the porcine anterior cruciate ligament
Open accessAbstract
Background: The anterior cruciate ligament (ACL) fails to heal after traumatic rupture. Furthermore, large-animal models have recently shown that 1-month functional ACL healing is augmented after suture repair when a bioactive scaffold is placed in the tear site. Hypothesis: At the time of suture repair, placement of a bioactive scaffold in the ACL wound site would improve the structural properties of the tissue. Study Design: Controlled laboratory study. Methods: Twenty-seven knees in immature pigs underwent ACL transection and suture repair. A collagen-platelet composite (CPC) was used to supplement the repair in 14 knees. Knees were harvested at 4 weeks, 6 weeks, and 3 months. Mechanical testing and histologic analysis were performed. Results: The addition of a CPC to a suture repair resulted in improvements in yield load and linear stiffness of the repair tissue at 3 months, as well as a significant increase in cell density. A reduction in yield load and stiffness occurred at the 6-week time point in both groups, a phase when revascularization was noted. Conclusion: The addition of a CPC to a suture repair enhanced the structural properties of the ACL, and the improvement was associated with increased cellularity within the healing ligament. Clinical Relevance: The addition of a bioactive scaffold to the wound site improved the functional healing of the ACL after suture repair. The decreased repair strength during revascularization may indicate a need to protect the repair site through this period.
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In an immature pig model of repaired ACL, the PRP group showed increased cellularity of the healing ligament with fusiform-shaped cells and decreased vascularity compared to controls at 3 months.
“After 3 months, the PRP group showed increased cellularity of the healing ligament with fusiform-shaped cells and decreased vascularity compared to controls.”
From Molecular and Biologic Effects of Platelet-Rich Plasma (PRP) in Ligament and Tendon Healing and Regeneration: A Systematic Review (2023) · cites this paper as [50]
The Results (Histomorphometry) report 25.5% higher cellularity and a higher proportion of fusiform cells in the collagen-platelet composite (CPC) group at 3 months. They also state that vascularity decreased in both groups, with no significant difference between them; the claimed decrease compared with controls is not supported. The treatment was CPC, not PRP alone. (LLM, conf=0.90)
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“[50] 2009 Pig 27 ACL (full thickness tear) control, collagen-PRP matrix 4,6 weeks, 3 months ↑ cellularity ≈ vascularity Increased number of fusiform-shaped cells”
BackgroundEffect of anterior cruciate healing on the uninjured ligament insertion site
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- Authors
- Joshi, S. M., Mastrangelo, A. N., Magarian, E. M., Fleming, B. C., & Murray, M. M.
- Affiliations
- Boston Children's Hospital (US)
- Brown University (US)
- Corresponding author
- Murray, Martha M.
- Venue
- The American Journal of Sports Medicine
- Publisher
- SAGE Publications
- Published
- 2009-11-25
- Volume
- 37
- Issue
- 12
- Pages
- 2401-2410
- ISSN
- 0363-5465 (ISSN-L)
- 1552-3365
- PMC
- PMC2856313
- OpenAlex
- W2164473845
- Cited by
- 175
- References
- 53
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 6 · 2023: 5 · 2022: 12 · 2021: 9 · 2020: 12 · 2019: 4 · 2018: 10 · 2017: 12 · 2016: 13 · 2015: 16 · 2014: 9 · 2013: 19 · 2012: 11
- FWCI
- 11.83
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR054099, AR052772, R01AR052772)
- Topics
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Health Sciences › Veterinary › Small Animals › Veterinary Orthopedics and Neurology
- Keywords
- anterior cruciate ligament, ligament healing, suture repair, bioactive scaffolds, ligament biomechanics, yield load, stiffness, revascularization, cell density, porcine model, ligament rupture
- MeSH terms
- Animals, Biomechanical Phenomena, Blood Platelets, Collagen, Random Allocation, Wound Healing, Anterior Cruciate Ligament, Treatment Outcome, Platelet Transfusion, Models, Animal, Sus scrofa, Tissue Scaffolds
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