Hasegawa Akihiko, Otsuki Shuhei, Pauli Chantal, Miyaki Shigeru, Patil Shantanu, Steklov Nikolai, Kinoshita Mitsuo, Koziol James, D'Lima Darryl D, Lotz Martin K
Department of Molecular and Experimental Medicine,The Scripps Research Institute, La Jolla, CA 92037, USA.
Arthritis Rheum. 2012 Mar;64(3):696-704. doi: 10.1002/art.33417.
The development and patterns of spontaneous age-related changes in the anterior cruciate ligament (ACL) and their relationship to articular cartilage degeneration are not well characterized. This study was undertaken to investigate the types and temporal sequence of age-related ACL changes and to determine their correlation with cartilage lesion patterns at all stages of osteoarthritis (OA) development in human knee joints without prior joint trauma.
Human knee joints (n = 120 from 65 donors ages 23-92) were obtained at autopsy, and ACLs and cartilage were graded macroscopically and histologically. Inflammation surrounding the ACL was assessed separately.
Histologic ACL substance scores and ligament sheath inflammation scores increased with age. Collagen fiber disorganization was the earliest and most prevalent change. The severity of mucoid degeneration and chondroid metaplasia in the ACL increased with the development of cartilage lesions. A correlation between ACL degeneration and cartilage degeneration was observed, especially in the medial compartment of the knee joint.
Our findings indicate that ACL degeneration is highly prevalent in knees with cartilage defects and may even precede cartilage changes. Hence, ACL deficiencies may not only be important in posttraumatic OA, but may also be a feature associated with knee OA pathogenesis in general.
前交叉韧带（ACL）与年龄相关的自发变化的发展和模式及其与关节软骨退变的关系尚未得到充分描述。本研究旨在调查与年龄相关的ACL变化的类型和时间顺序，并确定其与无既往关节创伤的人类膝关节骨关节炎（OA）发展各阶段软骨损伤模式的相关性。
在尸检时获取人类膝关节（来自65名年龄在23 - 92岁的供体，共120个膝关节），并对ACL和软骨进行宏观和组织学分级。分别评估ACL周围的炎症情况。
组织学上，ACL实质评分和韧带鞘炎症评分随年龄增加。胶原纤维紊乱是最早且最常见的变化。随着软骨损伤的发展，ACL中黏液样变性和软骨样化生的严重程度增加。观察到ACL退变与软骨退变之间存在相关性，尤其是在膝关节内侧间室。
我们的研究结果表明，ACL退变在有软骨缺陷的膝关节中非常普遍，甚至可能先于软骨变化出现。因此，ACL缺陷不仅在创伤后OA中很重要，而且可能也是一般膝关节OA发病机制的一个特征。
