Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160 012, India.
Int Orthop. 2010 Jun;34(5):737-41. doi: 10.1007/s00264-009-0948-1. Epub 2010 Feb 5.
To evaluate proprioceptive potential in residual remnants, tissue harvested from ruptured ACLs in 63 consecutive patients was examined for evidence of residual proprioceptive fibres using H&E, and monoclonal antibodies to S-100 and NFP (neurofilament protein). Histological examination showed good subsynovial and intra-fascicular vascularity with free nerve endings in the majority. Morphologically normal mechanoreceptors (H&E) and proprioceptive fibres (positivity with monoclonal antibody for NFP) were found in 46% and 52.4% of stumps, respectively. A statistically significant correlation between injury duration and persistence of mechanoreceptors and proprioceptive fibres was noted. More fibres were seen where ACL remnant was adherent to PCL. Our study has shown that persistent residual proprioceptive fibres in injured ACLs (especially early cases with PCL adherence) are significant; not shaving ACL remnants may be of potential benefit during ACL reconstruction, as some re-innervation and recovery of proprioceptive potential may be possible, thus improving clinical outcomes.
为了评估残端的本体感觉潜能,我们对 63 例连续前交叉韧带撕裂患者的组织进行了研究,使用 H&E 染色和 S-100 和 NFP(神经丝蛋白)单克隆抗体来检测是否存在残留的本体感觉纤维。组织学检查显示,大多数残端具有良好的滑膜下和束内血管生成,并有游离神经末梢。在 46%和 52.4%的残端中分别发现了形态正常的机械感受器(H&E)和本体感觉纤维(NFP 单克隆抗体阳性)。损伤持续时间与机械感受器和本体感觉纤维的持续存在呈显著相关。在 ACL 残端与 PCL 粘连的部位,纤维更多。我们的研究表明,受伤的 ACL 中存在持续的残留本体感觉纤维(尤其是与 PCL 粘连的早期病例)是显著的;在 ACL 重建过程中不修剪 ACL 残端可能会有潜在的益处,因为可能会发生一些再神经支配和本体感觉潜能的恢复,从而改善临床结果。