HEALING OF THE TRANSECTED ANTERIOR CRUCIATE LIGAMENT IN THE RABBIT

Healing of the anterior cruciate ligament was studied in 170 male rabbits. One group included immature animals that had open epiphyses, and a second group consisted of only mature animals. In one knee of each animal, the anterior cruciate ligament was transected either completely or partially, and in the contralateral knee a sham operation was carried out. Mechanical testing and histological studies of the ligaments were done immediately postoperatively and at two weeks, six weeks, three months, and one year. As we expected, there was no regeneration after complete transection of the anterior cruciate ligament, and all of the animals in which this procedure was done had severe osteoarthrosis of the joint at three months. Postoperatively, the partially sectioned ligaments exhibited one-third of the strength of the ligaments on the side on which the sham operation had been done in the immature animals and one-fourth of the strength of the ligaments on the side on which the sham operation had been done in the mature animals. Subsequently, there was secondary complete rupture of 20 per cent of the partially sectioned ligaments. The remaining 80 per cent of the partially sectioned ligaments were clearly weaker two weeks after the operation than immediately postoperatively, but this was also true on the side on which the sham operation had been done. At six weeks, the initial postoperative strength of the partially sectioned ligaments had been regained. At one year, the ligaments of the immature animals were two-thirds as strong as those on the contralateral side, and those of the mature animals were three-fourths as strong as those on the contralateral side. The ligaments were markedly elongated, especially in the mature animals. At three months, stiffness of the ligaments returned to normal. Histologically, the defect was filled with tissue that was still somewhat different from normal ligamentous tissue. CLINICAL RELEVANCE: Operative replacement of the anterior cruciate ligament has become a successful procedure for the treatment of ligamentous injuries in athletes. However, the natural history after such an injury is very variable, depending on the extent of concomitant ligamentous injuries and the level of activity. Clinical experience has shown that regeneration of the anterior cruciate ligament is poor, but there are no reliable experimental data, to our knowledge. Our experiments showed that no regeneration can be expected after a complete rupture of the ligament. After partial rupture, very slow and incomplete regeneration can be anticipated under favorable conditions.