Abstract

We investigated biomechanical and collagen expression in a healing bilateral rabbit medial collateral ligament (MCL) model to human recombinant transforming growth factor beta (rhTGF-β2) at three and six weeks. Each rabbit had rhTGF-β2 in a bioabsorbable pellet administered in one side, with the contralateral side serving as control (no rhTGF-β2). All MCL healed with rhTGF-β2 producing a profoundly increased scar mass at three weeks which decreased in size toward control at six weeks. In-situ hybridization demonstrated collagen expression (type I and III) no different than control at three weeks, but by six weeks elevated expression of type I was seen. Biomechanical analysis at three weeks showed no effect of rhTGF-β2 on structural properties. However, at six weeks rhTGF-β2 significantly inhibited both the maximum load ( p<0.05) and energy absorbed ( p<0.05) with no change in stiffness. Despite increased type I collagen expression and profound increase in early scar mass, rhTGF-β2 did not improve the structural properties. Whether the dose or mode of delivery is responsible for decline in structural properties cannot be determined in this design. We hypothesize investigations of healing ligaments to cytokines should have biologic and biomechanical properties correlated in the same study at a minimum of two time points.

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