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Anterior Cruciate Ligament deficiency leads to early instability of scaffold for cartilage regeneration: a controlled laboratory ex-vivo study

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Abstract

Purpose

The affect of anterior cruciate ligament (ACL) integrity on the early postoperative stability of a collagen type-I gel scaffold was investigated. The value of fibrin glue for graft fixation in ACL deficient porcine knees over a simulated early postoperative period was also studied.

Methods

Full-thickness articular cartilage defects (11 × 6 mm) were created on the medial femoral condyle of 80 porcine knees. The ACL was left intact or completely transected in each of 40 knees. Gel plugs were tested in each group: press-fitting only in 20 specimens and press-fitting plus fibrin glue in 20 specimens. Each knee underwent 2,000 cycles in a validated ex-vivo continuous passive motion model.

Results

Press-fit-only fixation grafts in knee specimens with an intact ACL showed significantly superior stability than that in ACL deficient knees (p = 0.01). In ACL deficient knees, grafts fixed with press-fitting plus fibrin glue showed significantly superior stability than those using press-fit only fixation (p = 0.01). Press-fitting plus fibrin glue fixation showed no significant differences in worn surface area between knee specimens with intact and deficient ACL.

Conclusions

ACL deficiency led to early scaffold instability in an ex-vivo porcine knee model. Fibrin glue in ACL deficient knees led to additional graft stability. These findings indicated that cartilage regenerative techniques may give optimum results in ACL intact knees.

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Conflict of interest

TE, TJH and MDS are consultants to Smith&Nephew, Arthroscopy, Germany. No benefits or funds were received in support of this study.

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Authors and Affiliations

  1. Department of Orthopaedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany

    Turgay Efe, Thomas J. Heyse, Susanne Fuchs-Winkelmann, Thilo Patzer, Bilal F. El-Zayat, Stefan Lakemeier & Markus D. Schofer

  2. Department of Oral and Maxillofacial Surgery, University Hospital Aachen, Aachen, Germany

    Alexander Füglein

  3. University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

    Alan Getgood

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  1. Turgay Efe
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Correspondence to Turgay Efe.

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Efe, T., Füglein, A., Getgood, A. et al. Anterior Cruciate Ligament deficiency leads to early instability of scaffold for cartilage regeneration: a controlled laboratory ex-vivo study. International Orthopaedics (SICOT) 36, 1315–1320 (2012). https://doi.org/10.1007/s00264-011-1437-x

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  • DOI: https://doi.org/10.1007/s00264-011-1437-x

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