InMotion Orthopaedic Research Center, Memphis, TN, USA.
Clin Orthop Relat Res. 2012 Jul;470(7):1855-9. doi: 10.1007/s11999-011-2120-7.
BACKGROUND: Although normal cruciate ligaments and those in patients with osteoarthritic (OA) knees contain mechanoreceptors, it is unclear whether they are present after functioning in a cruciate-retaining total knee arthroplasty (TKA). QUESTIONS/PURPOSES: We therefore determined if the areas occupied by mechanoreceptors in the human posterior cruciate ligament (PCL) are similar in patients with osteoarthritis and in patients who have had TKA with retention of the PCL. METHODS: We identified five cruciate-retaining TKA specimens from a retrieval program and obtained five PCLs during cruciate-sacrificing TKA from patients with OA; the retrieved specimens had been in place 5 to 12 years. The whole en bloc PCL specimens were harvested for the study. These specimens were then sectioned to a thickness of 8 μm and mounted on microscope slides. Two transverse cross-sections from the distal third from each specimen 100 μm apart were then subjected to immunohistochemistry with neurofilament protein (NFP) and S-100 protein. RESULTS: All five PCL specimens in each group revealed multiple areas of positive stained elements with both S-100 protein and NFP immunohistochemical staining. Morphologically, these elements appear to correspond to Pacinilike, Golgilike, and fusiform types of mechanoreceptors. We observed no difference in positive staining mechanoreceptor elements as a percentage of area in the osteoarthritis and TKA groups. CONCLUSION: Mechanoreceptors appear to occupy similar areas before and after implantation of a TKA. CLINICAL RELEVANCE: If mechanoreceptors continue to function after cruciate-retaining TKA, then it may continue to participate in proprioception of the knee after TKA.
背景:尽管正常的十字韧带和骨关节炎(OA)膝关节中的十字韧带含有机械感受器,但在保留十字韧带的全膝关节置换(TKA)中运作后,它们是否存在尚不清楚。
问题/目的:因此,我们确定了在骨关节炎患者和接受保留后十字韧带的 TKA 的患者中,人后十字韧带(PCL)中机械感受器占据的区域是否相似。
方法:我们从检索计划中确定了五个保留十字韧带的 TKA 标本,并从接受 OA 的 TKA 中获得了五个 PCL;检索的标本已经放置了 5 到 12 年。整个整块 PCL 标本都用于研究。然后将这些标本切成 8μm 的厚度并安装在显微镜载玻片上。然后对每个标本从远端三分之一处的两个横向横截面进行神经丝蛋白(NFP)和 S-100 蛋白的免疫组织化学染色。
结果:每组的五个 PCL 标本均显示出多个具有 S-100 蛋白和 NFP 免疫组织化学染色的阳性染色元素区域。从形态上看,这些元素似乎对应于 Pacinilike、Golgilike 和梭形机械感受器类型。我们观察到在骨关节炎和 TKA 组中,阳性染色机械感受器元素占区域的百分比没有差异。
结论:机械感受器在 TKA 植入前后似乎占据相似的区域。
临床相关性:如果保留十字韧带的 TKA 后机械感受器继续发挥作用,那么它可能会继续参与 TKA 后膝关节的本体感觉。
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