The medial collateral ligament of the knee joint of mature rabbits was ruptured manually. The animals were then treated by the following 9 different methods to make a comparison of their therapeutic efficacy :
I. No treatment (control group) .
II. Immobilization in a plaster cast.
III. Immobilization in a plaster cast, preceded by a 30-min, soaking in ice water with subsequent drying while compressed with sponge rubber.
IV. Intramuscular injection of alpha-chymotrypsin, 5 ch, u., for 6 consecutive days just after rupture of the ligament.
V. Immobilization in a plaster cast and the same treatment as IV.
VI. The intraligamentous injection of corticosteroid hormone (0.05 mg Dexamethasone) just after and the 5 th day of rupture of the ligament.
VII. The intraligamentous injection of corticosteroid hormone (0.05 mg Dexamethasone) given at the 5 th and 10 th day of rupture of the ligament.
VIII. Immobilization in a plaster cast and the same treatment as VI.
IX. Immobilization in a plaster cast and the same treatment as VII.
On each animal standardized x-ray examination of the knee joint was made 3 times, i.e., before and after rupture of the ligament and before sacrificing the animal, while valgus stress (a weight of 1 kg) was applied to the knee. Observation for changes in the affected region was made at 1, 2, 3, 5 and 8 weeks.
The results obtained may be summarized as follows :
1. The rupture of the ligament was associated, on many occasions, with avulsion of the periosteum from its tibial attachment.
2. Return of forced valgus angle just before sacrificing of animal to its pre-injury level was achieved at : the 2nd week in groups III and IX; the 3 rd week in groups II, IV, V and VII ; and the 5 th week in groups I, VI and VII. It is thus apparent that results were more favorable with the use of a plaster cast than without it.
3. Macroscopical findings :
Abnormalities were less prominent and less frequent in groups without immobilization. Contracture of the knee joint was seen at the 3 rd week in groups with immobilization.
4. Histological findings :
Subperiosteal callus formation was noted at the 1st week. In groups receiving alphachymotrypsin injection (IV and V) the formation of fibrous tissue was evident at the 2nd week. The repair of fibers of the ligament was complete at the 3 rd week in groups III and IX, at the 5 th week in groups II, IV, V, VII and VIII and at the 8 th week in group. I.
5. The degree of forced valgus angle was found to be well correlated with the rapidity with which fibers of the ligament were repaired. Based on these criteria, the therapeutic procedures may be arranged in descending order of efficacy as follows :
(1) III and IX, (2) V, (3) IV and VIII, (4) II, (5) VII, (6) VI, and (7) I.
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