Immature animals have higher cellular density in the healing anterior cruciate ligament than adolescent or adult animals

Abstract

There has been recent interest in the biologic stimulation of anterior cruciate ligament (ACL) healing. However, the effect of age on the ability of ligaments to heal has not yet been defined. In this study, we hypothesized that skeletal maturity would significantly affect the cellular and vascular repopulation rate of an ACL wound site. Skeletally Immature (open physes), Adolescent (closing physes), and Adult (closed physes) Yucatan minipigs underwent bilateral ACL transection and suture repair using a collagen-platelet composite. The response to repair was evaluated histologically at 1, 2, and 4 weeks. All three groups of animals had completely populated the ACL wound site with fibroblasts at 1 week. The Immature animals had a higher cellular density in the wound site than the Adult animals at weeks 2 and 4. Cells in the Immature ligament wounds were larger and more ovoid than in the Adult wounds. There were no significant differences in the vascular density in the wound site. Animal age had a significant effect on the density of cells populating the ACL wound site. Whether this observed cellular difference has an effect on the later biomechanical function of the repaired ACL requires further study.

Figure 1

Schematic of the augmented suture repair technique. Sutures are placed in the tibial stump, threaded through a collagen scaffold, and tied to sutures attached to a suture anchor in the femur. Collagen-platelet composite (CPC) is added onto the collagen sponge. [Color figure can be viewed in the online issue, which is available at http://www.interscience.wiley.com]