Donor cell survival and repopulation after intraarticular transplantation of tendon and ligament allografts.

The specific cells within ligaments and tendons are important to maintain the unique structural and material properties of these tissues. The use of tendon and ligament allografts with living cells for ligament reconstruction would be desirable assuming that these cells would survive after transplantation and continue to function. We assessed the fate of donor cells in fresh allografts of the patellar and anterior cruciate ligaments after transplantation. The cells in these allografts used to reconstruct the anterior cruciate ligament did not survive. This was demonstrated using a DNA probe technique that clearly distinguished donor cells from host cells in the Spanish goat model. The donor cells were replaced by host cells in a rapid manner. The host cells that repopulated the allografts assumed the histologic similarity to the fibroblasts they replace. Simultaneous full-thickness skin transplants in the same animals were not rejected during the interval of rapid loss of donor DNA from the allografts. The absence of rejection of the skin grafts at the one-week interval suggests that no pre-existing antibody associated with an immune reaction was responsible for the rapid loss of DNA in the allografts. The clinical basis for utilizing intra-articular allografts with living donor cells needs further justification to account for their increased expense, more complicated surgical logistics, and higher potential risk of disease transmission.