Comparative and morphological analysis of commonly used autografts for anterior cruciate ligament reconstruction with the native ACL: An electron, microscopic and morphologic study

Panayiotis T. Hadjicostas, Panayotis N. Soucacos, Nadezda Koleganova, Gerhard Krohmer, Irina Berger

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Ligaments and tendons are similar in composition but differ in proportion and arrangement. Tendons are being used as grafts for the ACL reconstruction. Their microscopic structure has not been sufficiently studied and compared to the native ACL. A null hypothesis was declared stating that the anterior cruciate ligament should be histological, morphologically and functionally different from the tendon grafts used for ACL reconstruction. We investigated similarities and differences of the structure of ACL and tendons used as a graft tissue for ACL reconstruction. In this study, standardized samples of quadriceps, hamstrings (semitendinosus and gracilis) and patellar tendons, and the ACL were harvested from 26 autopsies (average age 36.4) and were investigated using light and electron microscopy, immunohistochemistry and morphometry. The thickness of the collagen fibrils, collagen organization and diameter, the fibril/interstitium ratio, density of fibroblasts and blood vessels, and distribution of the collagen type I, III and V fibrils were analyzed. The semitendinosus showed the highest density of fibroblasts and blood vessels, while the gracilis the highest fibril/interstitium ratio. No differences regarding the thickness of collagen fibrils and distribution of fibrils were found. The ACL had the highest concentration of type III and V collagen fibrils as well as elastic fibers. The histological and ultrastructural appearance of the ACL differs from those of the tendons used as graft, for ACL reconstruction. Its ultrastructure is varied and complex, with its collagen fibers bundles lying in many directions.

Original languageEnglish
Pages (from-to)1099-1107
Number of pages9
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume16
Issue number12
DOIs
Publication statusPublished - Dec 2008

Keywords

  • ACL reconstruction
  • Cadaveric study
  • Comparative morphology
  • Morphometry
  • Tendon graft

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