Collagen alteration in medial collateral ligament healing in a rabbit model.

The purpose of this study was to evaluate changes over time in surgically ruptured medial collateral ligament (MCL) with respect to collagen synthesis, collagen degradation and collagen type. Our method involved prelabeling collagen in growing rabbits using 3H-proline followed by surgical injury to the MCL. Animals were sacrificed at intervals up to 40 weeks post-injury. At each time point total hydroxyproline, changes in collagen mass, and collagen synthesis and degradation were determined and related to the unruptured control MCL. A separate semiquantitative determination of collagen type was also performed on the midsubstance of each healing and control ligament. Results showed an increase in total collagen mass and a decrease in collagen concentration in all healing ligaments. Concommitantly, an increase in the collagen turnover rate was observed. Relative turnover was greatest at 3 to 6 weeks after injury and returned toward the normal rate by 40 weeks. Type I collagen was partially replaced by type III, probably as a result of increased synthesis during scar formation. The mechanism for collagen remodeling (replacement of mass and concentration in an organized fashion) in untreated rabbit MCL scar appears functional by virtue of its chronicity but, due to a shift in collagen type, it may also be qualitatively inadequate.