Delayed surgical repair of ruptured ligaments: a comparative biomechanical and histological study

The importance of prompt surgical repair of complete ligament ruptures was quantitated using 38 rabbits with standardized transection injuries ofthe medial collateral ligament of one knee. Tensile testing of the mechanical properties, coupled with histological evaluation allowed assessment of the integrity of suture repairs performed immediately after ligament injury, versus those with 3 and 10 day delay times as well as those with non-operative management. Surgical repair performed within the first 3 days is beneficial in terms of final repair strength. Irreversible ligament strength and stiffness deficits progressively accumulate during the 10 days immediately following injury. Surgical repair after more than 10 days postinjury is contraindicated since the postoperative mechanical properties of the healed ligament do not differ from those for non-operative injury management.