A biomechanical and histological evaluation of the structure and function of the healing medial collateral ligament in a goat model

This study evaluated the healing process of an isolated medial collateral ligament (MCL) rupture at 12 weeks in a goat model. Using a robotic/UFS testing system, knee kinematics in multiple degrees of freedom and in situ forces in the healing MCL in response to (1) a 67-N anterior tibial load and (2) a 5-Nm valgus moment were evaluated as a function of angles of knee flexion. Then a uniaxial tensile test of femur-MCL-tibia complexes (FMTCs) was preformed to obtain the structural properties of the FMTC and mechanical properties of the healing MCL substance. The histological appearance of the healing MCL was also examined for collagen and cell organization. The anterior tibial translation in response to a 67-N anterior tibial load was found to range from 1.9 to 2.4 mm, which was not significantly different from the sham-operated, contralateral control knee. In response to a 5-Nm valgus moment, however, MCL injury caused a 40% or more increase in valgus rotations over sham-operated controls for all angles of knee flexion tested. The magnitudes of the in situ forces in the healing MCLs for neither external loading conditions differed from sham-operated controls. For the structural properties of the healing FMTC, the stiffness returned to sham-operated control levels, but ultimate load at failure remained 60% of sham-operated control values. In terms of mechanical properties of the healing MCL, its tangent modulus and stress at failure were only 40% of sham-operated control values. Histologically, the collagen and cell organization at the femoral and tibial insertions as well as the midsubstance remained disorganized. Comparing these data to those previously reported at 6 weeks, there was a marked improvement in the in situ forces in the healing MCL and of the stiffness of the FMTC. Also, the data obtained for the goat model revealed a faster healing process than those for the rabbit model. These findings suggest that greater post-injury activity levels may render the goat to be a better animal model for studying the healing process of the MCL.