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PubMedDate not supplied

The predictive value of radiographs in the evaluation of unilateral and bilateral anterior cruciate ligament injuries.

A review of 250 cases of surgical reconstruction of the anterior cruciate ligament identified 24 patients with bilateral complete tears of the anterior cruciate ligament. Twenty of these patients had previous reconstruction of one anterior cruciate ligament before rupture of the opposite ligament. Twelve injuries occurred during the same activity that was responsible for the initial opposite injury. The average time between surgical reconstruction and rupture of the opposite ligament was 29.3 months (range, 3 to 103). No significant demographic differences existed between patients with unilateral or bilateral ruptures of the anterior cruciate ligament. Standardized measurements of intercondylar notch height and width and medial and lateral femoral condyle height and width were performed on routine notchview height and width were performed on routine notchview radiographs of 31 knees of patients with bilateral injuries, 30 with unilateral injury, and 30 with no anterior cruciate ligament injury. Statistical analysis revealed no significant differences between the three groups when comparing absolute measures or any of eight mathematical ratios calculated from these measurements. We concluded that measurements of the intercondylar notch made from radiographs may not be reliable predictors of injury to the anterior cruciate ligament. We found no significant clinical or demographic differences between patients with unilateral or bilateral complete ruptures of the anterior cruciate ligament.

Adolescent↗
PubMedDate not supplied

The role of the cruciate and posterolateral ligaments in stability of the knee. A biomechanical study.

The role of the posterolateral and cruciate ligaments in restraining knee motion was studied in 11 human cadaveric knees. The posterolateral ligaments sectioned included the lateral collateral and arcuate ligaments, the popliteofibular ligament, and the popliteal tendon attachment to the tibia. Combined sectioning of the anterior cruciate and posterolateral ligaments resulted in maximal increases in primary anterior and posterior translations at 30 degrees of knee flexion. Primary varus, primary internal, and coupled external rotation also increased and were maximal at 30 degrees of knee flexion. Combined sectioning of the posterior cruciate and posterolateral ligaments resulted in increased primary posterior translation, primary varus and external rotation, and coupled external rotation at all angles of knee flexion. Examination of the knee at 30 degrees and 90 degrees of knee flexion can discriminate between combined posterior cruciate ligament and posterolateral injury and isolated posterolateral injury. The standard external rotation test performed at 30 degrees of knee flexion may not be routinely reliable for detecting combined anterior cruciate and posterolateral ligament injury. However, measurements of primary anterior-posterior translation, primary varus rotation, and coupled external rotation may be used to detect combined anterior cruciate and posterolateral ligament injury.

Aged↗
PubMedDate not supplied

The role of the acromioclavicular ligaments and the effect of distal clavicle resection.

To determine the role of the acromioclavicular ligaments in controlling scapular rotation about the distal clavicle and the effects of distal clavicle resection, we used 13 fresh shoulders consisting of the clavicle, acromioclavicular ligaments, coracoclavicular ligaments, and scapula. The range of motion was measured using a specially designed goniometer for each of the three orthogonal axes of rotation of the scapula with reference to the clavicle: anterior-posterior axial rotation, protraction-retraction, and abduction-adduction. We did two experiments involving sequential sectioning. Range of motion was measured in the intact shoulder and after each sectioning cut. The order of sectioning in Experiment 1 (six shoulders) was 1) the inferior acromioclavicular ligament, 2) removal of 5 mm of the distal clavicle, and 3) the superior acromioclavicular ligament. In Experiment 2 (seven shoulders) the order was 1) the superior acromioclavicular ligament, 2) removal of 5 mm of the distal clavicle, and 3) the inferior acromioclavicular ligament. The most important results were 1) only 5 mm of the distal clavicle needs to be resected to ensure that no bone-to-bone contact occurs in rotation postoperatively and 2) there was no difference in the end result (for range of motion in any of the three axes) whether the inferior acromioclavicular ligament or the superior acromioclavicular ligament was cut before removal of 5 mm of the distal clavicle.

Acromioclavicular Joint↗
PubMedDate not supplied

Biomechanics of knee ligaments.

Significant advances have been made during the past 25 years in characterizing the properties of ligaments as a tissue and as an individual component in the bone-ligament-bone complex. The contribution of ligaments to joint function have also been well characterized. We have presented many studies that sought to characterize the tensile and viscoelastic properties of ligaments. As a result of these investigations, some of the most important experimental and biologic factors affecting the measurements of these properties have been identified and elucidated. The identification of the tensile properties of normal ligaments can serve as the basis for evaluating their success in healing and repair after injury. Furthermore, characterization of normal ligament function is crucial for diagnosing joint injuries as well as for evaluating reconstruction strategies and developing rehabilitation protocols. The recent introduction of robotic technology to the study of joint kinematics has resulted in significant advances in the understanding of the relative importance of ligaments to joint function. With the more accurate simulation of joint kinematics that include multiple degrees of freedom motion, data on the in situ forces in ligaments can be used to improve the treatment of ligament repair and reconstruction. More complex external loading conditions that mimic sports activities and rehabilitation protocols can also be introduced in the future. Furthermore, this technology can be extended to study other frequently injured joints, such as the shoulder.

Animals↗
PubMed2002

Simultaneous strain measurement with determination of a zero strain reference for the medial and lateral ligaments of the ankle.

The strain changes of the central part of the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL), the calcaneofibular ligament (CFL), and the tibiocalcaneal ligament (TCL) were measured simultaneously for a full range of ankle motion. Twelve fresh frozen amputated ankles were used. To measure the strain changes of the ligaments, a Galium-Indium-filled silastic strain transducer was implanted in the center of each ligament. The zero strain reference was determined immediately after the measurement of strain changes in five of the 12 ankles by tensile testing of each bone-ligament-bone preparation. The maximum strain change of the ATFL, the PTFL, the CFL and the TFL were 7.9%, 5.9%, 5.3% and 5.2%, respectively. The ATFL was elongated in plantar flexion and shortened in dorsiflexion. The PTFL and the CFL were shortened in plantar flexion and elongated in dorsiflexion. The TCL was the longest around the neutral position and became shorter in planter flexion and dorsiflexion. The results showed that the ATFL was taut in plantar flexion over 16.2 degrees, the PTFL and the CFL were taut in dorsiflexion over 18 degrees and 17.8 degrees respectively, and the TCL was taut between 9.5 degrees of dorsiflexion and 9.5 degrees of plantar flexion. The length change pattern was different among the ankle ligaments, although there was only a slight difference between that of the PTFL and the CFL. This study provides fundamental data useful in studying ankle ligament reconstruction.

Adolescent↗
PubMed1991

[Does partial anterior cruciate ligament rupture really exist?].

From 1983 to 1989 129 partial tears of the anterior cruciate ligament were diagnosed by arthroscopy. To confirm the diagnosis of a partial rupture of the anterior cruciate ligament, we began to split the synovial sheath of the anterior cruciate ligament in 1986 in order to prove the continuity of the fibers. Applying this technique, we quite often found the anterior cruciate ligament completely torn. Hence the rate of partial tears of the anterior cruciate ligament decreased from about 10% of all anterior cruciate ligament ruptures 1983 to about 3% 1989. 42 patients whose diagnosis had been a partial rupture of the anterior cruciate ligament were reviewed clinically to determine whether the anterior cruciate ligament injury had finally proved to be an insignificant lesion or had caused a knee instability. The overall results were very good in 12% and good in 14%; 41% showed a fair, 26% a poor result. Because of this unfavourable outcome, we believe that most of the partial tears of the anterior cruciate ligament should be regarded as complete ruptures.

Adolescent↗
PubMed1990

[Diagnosis and treatment of the cruciate ligament injury of knee joint].

During 1959 to 1986, 62 Cases with cruciate ligament injury of the knee joint were treated in our hospital. Thirty of these cases were anterior cruciate ligament injuries and 32 cases were posterior The diagnosis of the cruciate ligament injuries was made by stability tests of the cruciate ligament. When the knee was greatly swollen with multiple ligament injuries, a series of X-ray films should be taken to test the knee stability under local or nerve block anesthesia. Fresh tear of the cruciate ligament (33 cases) was treated with immediate surgical repair except in one. Old ligament injuries (28 cases) were treated by conservative method (10 cases) or surgical reconstruction (18 cases). All patients were followed for 2 to 18 years (mean 6 years). The results showed that the fresh tear of the cruciate ligament treated surgically had excellent and good rates in 87.9% (29/33). In the conservative treatment group, only 27.3% (3/11) obtained good result, and most of them were complicated with meniscal lesions and osteoarthritis. Eighteen cases treated by ligament reconstruction gave 34.5% (8/18) good result.

Adolescent↗
PubMed1994

[Long-term results of arthroscopic implantation of a Trevira prosthesis for replacement of the anterior cruciate ligament].

The present report describes the results of long-term follow-up after arthroscopic replacement of the anterior cruciate ligament with a synthetic ligament made of "Trevira-Hochfest". Over a period of 27 months 88 Trevira ligaments were implanted at the Department for Trauma Surgery of the Krankenhaus der Barmherzigen Brüder in Eisenstadt using the arthroscopic assisted two-drill-hole technique. The overall complication rate found after follow-up for up to seven years was 47.7% (42/88). In 14 patients ligament ruptures occurred within the first 24 months after surgery; a further 8 ruptures were seen in the subsequent years. Including the 12 instable knee joints found at the time of the follow-up, the overall rupture rate seen was 38.6% (34/88). In obvious contrast to reports on comparable synthetic ligaments, the ruptures seen invariably showed smooth rupture surfaces without any fraying. In all of the cases removal of the ruptured ligaments was possible without any problems. It is highly likely that this material-specific characteristic is also responsible for the comparably low incidence of synovitis (18%) with only one of our patients requiring an explantation of the synthetic ligament due to recurrent synovitis. Of the patients with intact Trevira ligaments excellent or good results in the OAK-Score were seen for 76.8% at follow-up after up to seven years. Follow-up stability tests performed in 69 patients showed intact Trevira-ligaments in 57 cases (82.6%). The radiographic findings obtained for the postoperative follow-up for up to seven years failed to show any clinical evidence of the arthrosis-promoting effects of foreign-body synovitis demonstrated in experimental models.

Adolescent↗
PubMed2002

Vascular physiology and long-term healing of partial ligament tears.

Functional outcomes of anterior cruciate ligament (ACL) injury are generally poorer than those of medial collateral ligament (MCL) tears. Following ligament damage, all phases of ligament healing require an adequate blood supply. We hypothesized that the differences in healing properties of the ACL and MCL would reflect their vascular responses to joint injury. This paper examines the long-term changes in blood flow and vascular volume of rabbit knee ligaments after direct injury, and under conditions of chronic joint instability induced by section of the posterior cruciate ligament (PCL). Standardized injuries were surgically induced in adult rabbit knee ligaments: partial MCL transection, partial ACL transection, or complete PCL transection (joint instability). Sixteen weeks later the blood flow and vascular volume of the ACL and MCL were measured and compared to control and sham-operated animals. Direct ligament injury induced significant increases in standardized blood flow and vascular volume of both ACL and MCL after 16 weeks; however, the vascular volume of the ACL was not higher than the control levels in the MCL. We conclude that direct injury to both the anterior cruciate and MCLs induces long-term physiological responses. Joint laxity is a common sequel to PCL injury. Chronic joint laxity failed to induce adaptive vascular responses in the ACL, while the MCL shows significant amplification of blood supply. Although both MCL and ACL showed increased weight after PCL transection, the lack of a long-term vascular response in the ACL may be a major factor in its the diminished healing potential.

Animals↗
PubMed1996

Quantitative comparison of soft tissue-bone interface at chondral ligament insertions in the rabbit knee joint.

At chondral ligament insertions the calcified fibrocartilage interdigitates deeply with the lamellar bone. The shape of this interface is formed under physiological loading conditions. For the purpose of morphological comparison between different ligament entheses in the rabbit knee, the number and frequency of interdigitations and thickness of calcified fibrocartilage were quantitated at the femoral insertion of the medial collateral ligament, both insertions of the cruciate ligaments, and the tibial insertion of the patellar ligament. Among the insertions, the femoral insertion of the medial collateral ligament showed the lowest frequency and depth of interdigitations at the soft tissue-bone interface, but had the thickest zone of calcified fibrocartilage. An inverse relationship was found at the insertion interface of the cruciate and patellar ligaments. The frequency and depth of interdigations at the bone-soft tissue interface at different chondral entheses seem to be related to the mechanical strength of the respective ligament; meanwhile it may be hypothesised that the thickness of the calcified fibrocartilage might be more related to the amount of motion which takes place at an insertion.

Animals↗
PubMed2002

Lumbar intrathecal ligaments.

A meticulous examination was performed on 56 vertebral columns from cadavers between 64 and 89 years of age. Identification of all contents within the dural sac was completed; however, the main focus was the cauda equina and lumbar region. In addition to scope dissection, radiographs and histological preparations were used to identify structures, tissue types, and any possible pathology. Discrete intrathecal ligamentous bands were observed in all cadavers examined. They were found randomly binding the dorsal nerve roots of the cauda equina to the dura. Occasional binding of the ventral nerve roots to the dorsal roots was observed. Histological examination demonstrated a dense collagen ligament varying between 0.13 and 0.35 microm in thickness and from 3 mm to 3.5 cm in length. The average number of ligaments found per cadaver was 18. These ligaments displayed a broad base attachment to the nerve root or dura of approximately 3 mm. Looping of the nerve roots associated with these ligaments was seen in one cadaver with a burst fracture. Electron microscopic studies of these ligaments demonstrated similarities to denticulate ligaments. It is suggested that the intrathecal ligaments represent remnants from fetal development of the denticulate ligaments.

Aged↗
PubMed2007

Cleland's and Grayson's ligaments of the hand: a morphometrical investigation.

The cutaneous ligaments of the human digits are delicate functional structures essential for normal skin stability during digital movements. These ligaments extend bilaterally between the phalanx and the finger dermis, either posteriorly (Cleland's ligaments) or anteriorly (Grayson's ligaments) to the digital neurovascular bundles. We have performed a series of detailed anatomical dissections of the human digits so as to investigate morphometrically Cleland's and Grayson's ligaments and their topographic arrangements. Data were statistically compared between fingers, respecting both side (left or right) and sex, in an attempt to clarify some of the morphologic variations of these structures. The cutaneous ligaments of the human digits have been analyzed bilaterally both in 30 fixed cadavers (300 adult human digits) and in 10 nonfixed human cadaveric digits. A computerized morphometrical investigation of the human digits and their Cleland's and Grayson's ligaments has been performed and the resulting quantitative data have been statistically assessed, comparing groups according to finger, phalanx, side (left or right hands), and sex. The ratio between the origin and insertion (O:I) of these ligaments indicate a divergent arrangement of fibers, with values varying from 0.52 to 0.84, depending on the phalanx and finger analyzed. Our morphometrical data provide normal reference values, mainly for Grayson's ligaments, that can be useful in the comparison with the respective measurements obtained in Dupuytren's disease. Morphological bases are also provided, which may be relevant either in computerized tomography or magnetic resonance imaging involving the hand region and in their application in surgical procedures of the human hand.

Adult↗
PubMed1994

Aging, vertebral density, and disc degeneration alter the tensile stress-strain characteristics of the human anterior longitudinal ligament.

The mechanical properties of the human lumbar anterior longitudinal ligament were investigated, and the influence of aging, disc degeneration, and vertebral bone density on these properties was determined. Tensile mechanical properties of the vertebra-anterior longitudinal ligament-vertebra complex were determined for 16 segments from cadavera of individuals who had been 21-79 years old (mean, 52.1 years) at the time of death. Regional strain patterns associated with three sites across the width and three sites along the length of the anterior longitudinal ligament were measured with use of a video-based motion analysis system. In the young, normal anterior longitudinal ligament, the elastic moduli of the insertion and substance regions of the ligament were similar (approximately 500 MPa). During aging (21-79 years), the elastic modulus of the substance region increased 2-fold, whereas the elastic modulus of the insertion decreased 3-fold; this resulted in an approximately 5-fold difference in elastic modulus between these regions in the older spine. The strength of the bone-ligament complex decreased approximately 2-fold (from 29 to 13 MPa) over this same age range. The outer portion of the anterior longitudinal ligament consistently had the highest peak tensile strains (11.8 +/- 2.7%) in all of the specimens examined. Preparations with nondegenerated discs and high bone density were significantly stronger (66%) and failed in the ligament substance; in contrast, segments from older individuals with degenerated discs and lower bone density failed in the ligament insertion regions.

Adult↗
PubMed1994

Influence of exogenous growth factors on the expression of plasminogen activators and plasminogen activator inhibitors by cells isolated from normal and healing rabbit ligaments.

In this investigation, we demonstrate that cells from normal and healing rabbit ligaments are selective in their responsiveness to various growth factors. The cells analyzed included fibroblasts isolated from the synovium, the anterior cruciate ligament, and the medial collateral ligament (midsubstance and epiligament). Fibroblasts isolated from scar tissue of medial collateral ligament that had been allowed to heal for 3 weeks also were analyzed. The addition of insulin-like growth factor-2 or transforming growth factor-beta 1 was observed to alter, in a dose-dependent manner, the expression of plasminogen activator and plasminogen activator inhibitor by connective tissue cells. However, the response to these growth factors was cell specific. Fibroblasts isolated from the midsubstance, epiligament, and scar tissue of the medial collateral ligament were responsive to these growth factors; fibroblasts isolated from the anterior cruciate ligament and synovium did not have a detectable response. The cells from the normal and healing medial collateral ligament responded to both growth factors by increasing plasminogen activator inhibitor activity. This was observed at both the protein and RNA level. In contrast, the addition of insulin-like growth factor-1 or acidic or basic fibroblast growth factor to cells derived from normal or healing ligament did not result in any detectable alteration of plasminogen activator or plasminogen activator inhibitor activity. These results are similar to those observed with an explant system and indicate that cells isolated from ligament tissue maintain their responsiveness to these growth factors in the absence of matrix. As the major effect of insulin-like growth factor-2 and transforming growth factor-beta 1 on the cells tested was to increase plasminogen activator inhibitor activity, such an alteration should diminish the activity of plasminogen activator, an enzyme capable of directly and indirectly proteolyzing matrix molecules, and thus contribute to a more anabolic environment.

Animals↗
PubMed1994

Maturation-related biochemical changes in swine anterior cruciate ligament and tibialis posterior tendon.

In order to determine the differences between ligaments and tendons in terms of change in biochemical composition during maturation, the biochemical characteristics of the anterior cruciate ligament and tibialis posterior tendon of swine were studied. The collagen content of the tibialis posterior tendon was found to increase rapidly with growth of the body, reaching a plateau prior to maturation. In contrast, the rate of increase in the anterior cruciate ligament was slow, indicating that maturation of this tissue is delayed. The quantity of glycosaminoglycan in both the anterior cruciate ligament and the tibialis posterior tendon decreased with growth. In mature animals, glycosaminoglycans in the anterior cruciate ligament included chondroitin sulfate, hyaluronic acid, and dermatan sulfate, but only trace amounts of chondroitin sulfate were found in the tibialis posterior tendon. Although the ratio of dermatan sulfate to hyaluronic acid generally increased with growth, this increase was more conspicuous in the tibialis posterior tendon than in the anterior cruciate ligament. The anterior cruciate ligament and tibialis posterior tendon both contained collagen of types I, III, and V. In mature swine, type III was increased in the anterior cruciate ligament but not in the tibialis posterior tendon. These findings demonstrate slower maturation for ligament than for tendon with regard to the changes in biochemical constituents, especially those in collagen type and glycosaminoglycan, during the growth process, and also suggest that the composition of these tissues changes in accordance with their changing functional requirements.

Animals↗
PubMed1995

Combined knee loading states that generate high anterior cruciate ligament forces.

Injuries to the anterior cruciate ligament frequently occur under combined mechanisms of knee loading. This in vitro study was designed to measure levels of ligament force under dual combinations of individual loading states and to determine which combinations generated high force. Resultant force was recorded as the knee was extended passively from 90 degrees of flexion to 5 degrees of hyperextension under constant tibial loadings. The individual loading states were 100 N of anterior tibial force, 10 Nm of varus and valgus moment, and 10 Nm of internal and external tibial torque. Straight anterior tibial force was the most direct loading mechanisms; the mean ligament force was approximately equal to applied anterior tibial force near 30 degrees of flexion and to 150% of applied tibial force at full extension. The addition of internal tibial torque to a knee loaded by anterior tibial force produced dramatic increases of force at full extension and hyperextension. This loading combination produced the highest ligament forces recorded in the study and is the most dangerous in terms of potential injury to the ligament. In direct contrast, the addition of external tibial torque to a knee loaded by anterior tibial force decreased the force dramatically for flexed positions of the knee; at close to 90 degrees of flexion, the anterior cruciate ligament became completely unloaded. The addition of varus moment to a knee loaded by anterior tibial force increased the force in extension and hyperextension, whereas the addition of valgus moment increased the force at flexed positions. These states of combined loading also could present an increased risk for injury. Internal tibial torque is an important loading mechanism of the anterior cruciate ligament for an extended knee. The overall risk of injury to the ligament from varus or valgus moment applied in combination with internal tibial torque is similar to the risk from internal tibial torque alone. External tibial torque was a relatively unimportant mechanism for generating anterior cruciate ligament force.

Aged↗
PubMed1996

Myofibroblasts in the healing lapine medial collateral ligament: possible mechanisms of contraction.

The specific objective of this study was to determine the chronology of the appearance of the myofibroblast in the healing ligament. The overall goal of our work is to elucidate the cellular mechanism of contraction in this tissue. The myofibroblast has been found to be responsible for wound contraction in many tissues and to be the cause of the contracture in several pathological conditions. This cell type contains the actin isoform previously thought to be unique to smooth muscle cells and displays certain characteristic features at the ultrastructural level. In 26 New Zealand White male rabbits, the right medial collateral ligament was transected, whereas the left medial collateral ligament received a sham operation. The central third of the ligament (ligament scar tissue) was evaluated at 2, 3, 6, 8, 10, and 12 weeks postoperatively by immunohistochemical techniques, transmission electron microscopy, and Western blot analyses. Three other rabbits served as anatomic controls. During the early reparative phase (2 and 3 weeks after transection), there was an increase in the number of cells containing alpha-smooth muscle actin as well as augmentation of the alpha-smooth muscle actin content within each cell--a finding attributed to smooth muscle cells and pericytes associated with neovascularity. No myofibroblasts were detected at this stage, immediately postoperatively, or in the sham-operation controls. Ligaments in the remodeling phase of healing (6, 8, 10, and 12 weeks) exhibited alpha-smooth muscle actin in fibroblasts (myofibroblasts) as well as in vascular pericytes and smooth muscle cells. During this stage of healing, transmission electron microscopy demonstrated an increase in the number of cells displaying myofibroblastic features. It was estimated that at 12 weeks of healing 10% of the cells at the site of injury were myofibroblasts. This is the first definitive finding of myofibroblasts in the injury site of the healing ligament, to our knowledge. The appearance of myofibroblasts in the 6-12 week healing period, the interval during which the ligament has been shown to contract in studies by other investigators, is a rationale for a hypothesis that a cellular contractile apparatus comprising alpha-smooth muscle actin (i.e., the myofibroblast) may contribute to the recovery of original ligament length (and normal in situ strain).

Actins↗
PubMed2000

Migration of cells from human anterior cruciate ligament explants into collagen-glycosaminoglycan scaffolds.

Regeneration of the human anterior cruciate ligament after complete rupture offers several theoretical advantages over reconstruction, including maintenance of the complex insertion sites and fan-shape of the ligament and preservation of remaining proprioceptive fibers within the ligament substance. Well vascularized connective tissues, such as dermis, heal as a result of migration of fibroblasts into a provisional scaffold, the fibrin clot. Wound closure is subsequently facilitated by a contractile cell phenotype. This study was designed to determine if fibroblasts intrinsic to the human anterior cruciate ligament were capable of migrating from their native extracellular matrix onto an adjacent provisional scaffold in vitro. Another objective was to determine whether any of the cells that successfully migrated into the scaffold expressed the contractile actin isoform, alpha-smooth muscle actin, associated with wound contraction in other tissues. The results demonstrated that the cells intrinsic to the human anterior cruciate ligament were able to migrate into a collagen-glycosaminoglycan scaffold, bridging a gap between transected fascicles in vitro. As a result of this cell migration and proliferation, areas in the scaffold contained cell number densities similar to those seen in the human anterior cruciate ligament in vivo. No extracellular matrix or tissue formation was seen in the gap between directly apposed transected ends of the anterior cruciate ligament explants cultured without an interposed collagen-glycosaminoglycan scaffold. The fascicle-collagen-glycosaminoglycan-fascicle constructs and the fascicle-fascicle explants displayed minimal adherence after 6 weeks in culture. Any disruption in the contact area between explant and scaffold, even as small a gap as 50 microm, prevented cell migration from the explant to the collagen-glycosaminoglycan scaffold at the area of loss of contact. All cells that migrated into the scaffold at early time periods expressed the alpha-smooth muscle actin isoform. These results demonstrate that cells that migrate into and proliferate within the collagen-glycosaminoglycan matrix have contractile potential as reflected in their expression of the alpha-smooth muscle actin isoform. The role of these contractile cells in the healing process warrants further investigation. Moreover, this study demonstrates the potential of cells intrinsic to the human anterior cruciate ligament to migrate into collagen-glycosaminoglycan scaffolds that may ultimately be investigated as implants to facilitate ligament healing and regeneration.

Actins↗