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Histological Study of the Anterior Cruciate Ligament in Patients with Osteoarthritis
Author(s) -
Komro Jack,
Gonzales Joshua,
Marberry Kevin,
Main Christopher,
Kondrashov Peter
Publication year - 2019
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2019.33.1_supplement.452.8
Subject(s) - medicine , anterior cruciate ligament , osteoarthritis , connective tissue , adipose tissue , tibia , orthopedic surgery , ligament , cruciate ligament , rheumatology , femur , anatomy , pathology , surgery , alternative medicine
The anterior cruciate ligament (ACL) plays a crucial role in preventing the anterior translocation and medial rotation of the tibia against the femur. The normal histological composition of the ACL has been described as 99% dense regular connective tissue (DRCT), 0.9% loose connective tissue, and 0.1% vasculature with no nerves or adipose tissue present. Previous data on ACL structure in patients with knee osteoarthritis (OA) indicate that the ligament undergoes degenerative changes in OA patients. The objective of the current study was to evaluate the details of histological changes in the ACLs of patients with clinically diagnosed OA. The study was approved by the local institutional review board. The ACLs from six patients undergoing total knee replacement because of OA (OA group) and eleven normal ACLs from the Kirksville College of Osteopathic Medicine anatomy lab (control group) were collected. Demographic data, medical history, and Outerbridge scores were also collected. The average Outerbridge score in the OA group was 3.6 on a scale of 0–4. Nonconsecutive 10 μm longitudinal tissue slices of ACLs stained with hematoxylin and eosin were analyzed for tissue composition and amount of blood vessels. To account for possible differences in tissue composition across the ligament, the full length and full thickness of each ACL were analyzed using nine sections from each ACL, from which the data were averaged. ImageJ software was used to calculate percentages for total area and areas of DRCT, degenerative tissue, and vasculature. Generalized linear mixed models were used to compare tissue composition and relative amount of blood vessels in the OA and control groups. There was no significant difference in tissue composition or vasculature between age groups (both P >.37). The major difference in the histological structure of the ACL between the two groups was the proportion of DRCT to non‐DRCT, which was significantly smaller in the OA group than the control group (OA, 50%; control, 96%; P <.001). The non‐DRCT included degenerative connective tissue and fibrocartilage. The ratio of blood vessels to area was greater in the OA group than the control group (OA, 0.12 vessels/mm 2 ; control, 0.02 vessels/mm 2 ; P =.01). These results indicate that the inflammatory processes in the knee contributing to OA lesions cause changes in the composition of the ACL that lead to destruction of collagen bundles, increased vascularization, edema, and formation of fibrocartilage‐like tissue inside the ligament. Thus, the ACLs from patients with severe OA undergo marked histological changes, making them less suitable for ligament‐retaining total knee arthroplasty. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .