Histopathological study in acute rupture of the anterior cruciate ligament of the knee.
DOI:
https://doi.org/10.15417/705Keywords:
anterior cruciate ligament, ACL, Histopathology.Abstract
Introduction
The histological structure of the ligaments, including the ACL, is composed of collagen and elastin wrapped in a matrix of water and proteoglycans. Collagen is the main component of tendons and ligaments, accounting for 65-75% of its dry weight. The aim of the present study is performing a histopathological evaluation of the ruptured ACL fragments taken at the time of the surgical procedure by arthroscopy.
Material and methods
A prospective observational study of 50 cases with ACL rupture. LCA samples were taken in an arthroscopic procedure and the histopathology of the ligament was evaluated.
Results
The results are mentioned based on results of pathological anatomy and post-operative evolution.
Conclusion
Degenerative changes were evidenced in the histopathology that can not be demonstrated if these changes are previous or posterior to the ligament rupture.
Downloads
References
G. Azangwe, K. J. Mathias, D. Marshall. Macro and microscopic examination of the ruptured surfaces of anterior cruciate ligaments of rabbits. J Bone Joint Surg Br 2000;82(3):450-456. DOI: https://doi.org/10.1302/0301-620X.82B3.0820450
Miyasaka KC, Daniel DM, Stone ML, Hirshman P. The incidence of knee ligament injuries in the general population. American Journal of Knee Surgery 1991;4:3-8.
Shino K, Oakes BW, Horibe S, Nakata K, Nakamura N. Collagen fibril populations in human anterior cruciate ligament allografts. Electron microscopic analysis. Am J Sports Med 1995 Mar-Apr;23(2):203-8; discussion 209. DOI: https://doi.org/10.1177/036354659502300213
Gao F, Zhou J, He C, Ding J, Lou Z, Xie Q, Li H, et al. A Morphologic and Quantitative Study of Mechanoreceptors in the Remnant Stump of the Human Anterior Cruciate Ligament. Arthroscopy 2016. DOI: https://doi.org/10.1016/j.asmart.2016.07.085
Feb;32(2):273-80. doi: 10.1016/j.arthro.2015.07.010. Epub 2015 Oct 1. DOI: https://doi.org/10.1016/j.arthro.2015.07.010
Butler DL, Guan Y, Kay MD, Cummings JF, Feder SM, Levy MS. Location-dependent variations in the material properties of the anterior cruciate ligament. J Biomech 1992 25:511–518. DOI: https://doi.org/10.1016/0021-9290(92)90091-E
Chandrashekar N, Mansouri H, Slauterbeck J, Hashemi J. Sex- based differences in the tensile properties of the human anterior cruciate ligament. J Biomech 2006 39:2943–2950. DOI: https://doi.org/10.1016/j.jbiomech.2005.10.031
Suzuki D, Otsubo H, Watanabe T,Kamiya T, Nagoya S, Yamashita T, Shino K. Ultrastructure of the three anterior cruciate ligament bundles. Clin Anat 2015 Oct;28(7):910-6. doi: 10.1002/ca.22586. Epub 2015 Jun 28. DOI: https://doi.org/10.1002/ca.22586
Strocchi R, Pasquale V, Gubellini P, Facchini A, Maracci M, Buda R, Zaffagnini S, Ruggeri A. The human anterior cruciate ligament: histological and ultrastructural observations. J Anat 1992 Jun; 180(Pt 3): 515–519.
Oka S, Schuhmacher P, Brehmer A, Traut A, Kirsch J, Siebold R. Histological analysis of the tibial anterior cruciate ligament insertion. Knee Surg Sports Traumatol Arthrosc. 2016 Mar;24(3):747-53. doi: 10.1007/s00167-015-3924-x. Epub 2015 Dec 19. DOI: https://doi.org/10.1007/s00167-015-3924-x
Mall NA, Frank RM, Saltzman BM, Cole BJ, Bach BR. Results After Anterior Cruciate Ligament Reconstruction in Patients Older Than 40 Years: How Do They Compare With Younger Patients? A Systematic Review and Comparison With Younger Populations. Sports Health. 2016 Mar-Apr;8(2):177-81. DOI: https://doi.org/10.1177/1941738115622138
Vaishya R, Kumar Agarwal A, Ingole S, Vijay V. Current Trends in Anterior Cruciate Ligament Reconstruction: A Review. Cureus. 2015 Nov; 7(11): e378. DOI: https://doi.org/10.7759/cureus.378
Gwinn DE, Wilckens JH, McDevitt ER, Ross G, Kao TC: The relative incidence of anterior cruciate ligament injury in men and women at the United States Naval Academy. Am J Sports Med. 2000, 28:98–102. DOI: https://doi.org/10.1177/03635465000280012901
Chahla J, Arroquy D, Perez Herrera G, Orlowski B, Guiñazu J, Carboni M, Vilaseca T. Lesión del Ligamento Cruzado Anterior: ¿Es la Disminución en la Movilidad de la Cadera un Factor Predisponente? Artroscopia Vol. 21, No 4 : 121-123 | 2014
Uhorchak, J.M., C.R. Scoville, G.N. Williams, R.A. Arciero, P. St Pierre, D.C. Taylor, Risk factors associated with noncontact in- jury of the anterior cruciate ligament: a prospective four-year eval- uation of 859 West Point cadets. Am J Sports Med, 2003. 31(6): p. 831-842. DOI: https://doi.org/10.1177/03635465030310061801
Eiling, E., A. L. Bryant, W. Petersen, A. Murphy, and E. Hohmann, Efects of menstrual-cycle hormone uctuations on musculotendinous sti fness and knee joint laxity. Knee Surg Sports Traumatol Arthrosc, 2007. 15(2): p. 126-132. DOI: https://doi.org/10.1007/s00167-006-0143-5
Iwaki, H., V. Pinskerova, and M.A. Freeman, Tibiofemoral move- ment 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br, 2000. 82(8): p. 1189-1195. DOI: https://doi.org/10.1302/0301-620X.82B8.0821189
Meister, K., M.C. Talley, M.B. Horodyski, P.A. Indelicato, J.S. Hartzel, and J. Batts, Caudal slope of the tibia and its relationship to noncontact injuries to the ACL. Am J Knee Surg, 1998. 11(4): p. 217-219. DOI: https://doi.org/10.1097/00005768-199805001-00268
Vaishya R , Hasija R: Joint hypermobility and anterior cruciate ligament injury . J Orthop Surg (Hong Kong). 2013, 21:182–84. DOI: https://doi.org/10.1177/230949901302100213
Danylchuck, K.D., Finaly, J.B., Krcek J.P. Microstructural organization of human and bovine cruciate ligaments. Clinical Orthopaedics and Related Research. 1978. 131 : 294 - 298. DOI: https://doi.org/10.1097/00003086-197803000-00048
Ho Chen H, Lintner M, Luo Z. Observation of the ultrastructure of anterior cruciate ligament graft by atomic force microscopy. Scanning. 2009 Jan-Feb;31(1):19-23. doi: 10.1002/sca.20137. DOI: https://doi.org/10.1002/sca.20137
Bayat, M; Mohammadzade, F; Rakhshan, M. Electron And Light Microscopic Study Of Anterior Cruciate Ligament Of Rabbit. J Anat. Soc. India 2003 52(2) 155-158
Dodds J.A. and Arnoczky, S.P. (1994) : Anatomy of the anterior cruciate ligament : a blue print for repair and reconstruction. Arthroscopy. 10(2):132- 139. DOI: https://doi.org/10.1016/S0749-8063(05)80080-5
Simokochi Y, Shultz S. Mechanisms of noncontact anterior cruciate ligament injury. J Athl Train. 2008 Jul-Aug;43(4):396-408. doi: 10.4085/1062-6050-43.4.396. DOI: https://doi.org/10.4085/1062-6050-43.4.396
Parry DA, Barnes GR, Craig AS. A comparison of the size distribution of collagen fibrils in connective tissues as a function of age and a possible relation between fibril size distribution and mechanical properties. Proc R Soc Lond B Biol Sci. 1978 Dec 18;203(1152):305-21. DOI: https://doi.org/10.1098/rspb.1978.0107
Haus BM, Mastrangelo AN, Murray MM. Effect of ante- rior cruciate healing on the uninjured ligament insertion site. J Orthop Res 2012;30:86-94. DOI: https://doi.org/10.1002/jor.21498
Downloads
Additional Files
Published
Issue
Section
License
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
