HEALING CHARACTERISTICS OF A TYPE-I COLLAGENOUS STRUCTURE TREATED WITH CORTICOSTEROIDS

One hundred twenty-eight skeletally mature New Zealand White rabbits w ere used to study the effect of a single corticosteroid injection on t he biomechanical, biochemical, and histologic aspects of ligamentous h ealing. Two steroid dosages were used. The amount of the low-dose ster oid was calculated by determining the corticosteroid concentration at which fibroblastic synthesis of collagen was inhibited in vitro. A hum an equivalent dose of betamethasone was used as the high-dose steroid injection. These two steroid doses and a saline control were injected around a transected medial collateral ligament. At 10 days all groups showed significantly inferior biomechanical properties relative to non injected controls. By 3 weeks the human equivalent steroid dose group continued to demonstrate significantly inferior properties. Histologic and biochemical analyses confirmed the biomechanical results. The cli nical relevance of the study was that the delivery of a human equivale nt steroid dose into an acutely injured ligament significantly impairs the healing process relative to a noninjected ligament at 1 0 days an d at 3 weeks after injury. This implies that a corticosteroid-treated injured ligament may not be able to withstand the mechanical loads of early vigorous rehabilitation.