A comparative study of collagen morphology and joint strength in anterior cruciate ligament repair and reconstruction models in rabbits

Vet World Vol.18 May-2025 Article - 23

Research Article

Veterinary World, 18(5): 1313-1321

https://doi.org/10.14202/vetworld.2025.1313-1321

Andre Yanuar^1,2

, Andi Isra Mahyuddin³

, Nucki Nursjamsi Hidajat⁴

, Hasrayati Agustina⁵

, Nicolaas Cyrillus Budhiparama^6,7

, and Nur Atik⁸

1. Doctoral Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.

2. Department of Orthopaedic and Traumatology, Santo Borromeus Hospital, Bandung, West Java, Indonesia.

3. Faculty of Mechanical and Aerospace Engineering, Institut Teknologi Bandung (ITB), Bandung, West Java, Indonesia.

4. Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.

5. Department of Pathology Anatomy, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.

6. Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.

7. Department of Orthopaedics, Leiden University Medical Centre, Leiden, Netherlands.

8. Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.

Background and Aim: Anterior cruciate ligament (ACL) repair offers several theoretical advantages over reconstruction, including preservation of native proprioception and reduced donor-site morbidity. However, the current experimental models are predominantly limited to ACL reconstruction, leaving a critical gap in ACL repair research. This study introduces a novel rabbit model to evaluate osteointegration and mechanical strength at the tendon/ligament-bone interface following ACL repair and reconstruction.

Materials and Methods: Six male New Zealand White rabbits (Oryctolagus cuniculus), aged 90 ± 0 days and weighing 2.50 ± 0.20 kg, were randomly assigned to two groups: ACL reconstruction (n = 3) using the extensor digitorum longus tendon graft and ACL repair (n = 3) using the Krackow suture technique at the femoral attachment. Specimens were collected 6 weeks postoperatively for histological evaluation of Sharpey’s-like fibers, immunohistochemical analysis of types I and III collagen, and biomechanical tensile testing.

Results: All surgical procedures were completed without complications. Histological analysis showed greater numbers of Sharpey’s-like fibers in the reconstruction group (6.33 ± 0.58%) compared to the repair group (5.67 ± 1.6%), though not statistically significant (p > 0.05). Type I collagen fibers were significantly longer in the reconstruction group in both longitudinal (3.10 ± 0.05 μm vs. 2.97 ± 0.04 μm) and transverse (1.94 ± 0.09 μm vs. 1.81 ± 0.05 μm) dimensions (p < 0.05). Type III collagen dimensions did not differ significantly. The mean tensile failure load was higher in the reconstruction group (105.96 ± 63.37 N) than in the repair group (62.56 ± 20.11 N), though this difference was not statistically significant (p > 0.05).

Conclusion: This study establishes a reproducible and cost-effective ACL repair model in rabbits and confirms that tendon-bone osteointegration occurs in both ACL repair and reconstruction. Superior biomechanical strength and enhanced type I collagen integration in the reconstruction group underscore current clinical outcomes favoring reconstruction. This model offers a valuable platform for exploring biological augmentation strategies to enhance ACL repair efficacy.

Keywords: anterior cruciate ligament repair, biomechanics, osteointegration, rabbit model, type I collagen.

How to cite this article: Yanuar A, Mahyuddin AI, Hidajat NN, Agustina H, Budhiparama NC, and Atik N (2025) A comparative study of collagen morphology and joint strength in anterior cruciate ligament repair and reconstruction models in rabbits, Veterinary World, 18(5): 1313-1321.

Received: 06-01-2025 Accepted: 23-04-2025 Published online: 25-05-2025

Corresponding author: Nur Atik E-mail: n.atik@unpad.ac.id

DOI: 10.14202/vetworld.2025.1313-1321

Copyright: Yanuar, et al. This article is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.