What's new in orthopaedic research

TY - JOUR

T1 - What's new in orthopaedic research

AU - Maher, Suzanne A.

AU - Hidaka, Chisa

AU - Cunningham, Matthew E.

AU - Rodeo, Scott A.

N1 - Funding Information: The anterior cruciate ligament continues to be an area of intense investigation. It is well established that the intra-articular anterior cruciate ligament has very little healing potential, in contrast with extra-articular ligaments such as the medial collateral ligament. Healing in extra-articular ligaments begins with the formation of a fibrin clot that acts as a scaffold to bridge the ends of the torn ligament. It is believed that a key factor in the inability of the anterior cruciate ligament to heal relates to the premature loss of the provisional fibrin clot scaffold due to plasmin in the synovial fluid. This hypothesis is supported by ongoing work in the laboratory of Murray and colleagues at Harvard Medical School. Those investigators found that healing of a central defect in the canine anterior cruciate ligament could be improved with use of a collagen-platelet-rich plasma hydrogel in the wound site 42 . Treatment of the intra-articular wound with a collagen-platelet-rich plasma hydrogel resulted in increased filling of the wound site with repair tissue. Furthermore, this repair tissue had growth-factor and protein-expression profiles similar to those seen in a healing extra-articular ligament (the medial collateral ligament). In a further extension of this work, the authors performed bilateral anterior cruciate ligament transections in Yorkshire pigs 43 . In each animal, one side was treated with suture repair alone whereas the other side was treated with suture repair and augmented with the placement of a collagen-platelet-rich plasma hydrogel at the anterior cruciate ligament transection site. The authors found significant improvements in load at yield, maximum load, and linear stiffness at four weeks in the ligament treated with the collagen-platelet-rich plasma hydrogel. That study suggests that there is adequate intrinsic cellular and vascular response in the injured anterior cruciate ligament to support functional healing if an appropriate scaffold is provided. Further extension of this work may ultimately allow repair of the anterior cruciate ligament instead of replacement with a tendon graft.

PY - 2008/8/1

Y1 - 2008/8/1

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U2 - 10.2106/JBJS.H.00739

DO - 10.2106/JBJS.H.00739

M3 - Review article

C2 - 18676928

AN - SCOPUS:48749112967

SN - 0021-9355

VL - 90

SP - 1800

EP - 1808

JO - Journal of Bone and Joint Surgery - Series A

JF - Journal of Bone and Joint Surgery - Series A

IS - 8

ER -