Department of Orthopedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
Department of Medical Pathology, Bilim University, Istanbul, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2017 Oct;25(10):3146-3154. doi: 10.1007/s00167-016-4221-z. Epub 2016 Jun 23.
Impaired proprioception accuracy of the knee has been proposed as a local factor in the onset and progression of knee osteoarthritis. Patients with decreased numbers of mechanoreceptors could be more likely to develop arthrosis due to a loss in proprioception of the joint. We aimed to identify and quantify the mechanoreceptors of the posterior cruciate ligament (PCL), the anterior capsule (AC) and the medial meniscocapsular junction (MCJ) in knee arthrosis.
PCLs, ACs and MCJs were harvested from 30 patients with Kellgren and Lawrence grades 3 and 4 osteoarthritis (OA), and ten knees taken from five cadavers without OA were used as a control group. PCL degeneration was evaluated with haematoxylin & eosin, and the types and numbers of mechanoreceptors were evaluated using S100 immunostaining.
The patient ages in the OA and control groups (n.s.) did not differ. PCL degeneration was more severe in the gonarthrosis group than in the control group (p = 0.04). The numbers of Golgi corpuscles, Ruffini corpuscles, free nerve endings, total nerve endings and small vessels of the PCL were low in the OA group, as were the numbers of Golgi corpuscles, free nerve endings and total nerve endings of the AC. No significant correlation was found regarding the mechanoreceptors of the MCJ between the two groups.
The numbers of mechanoreceptors in patients with OA were low in the PCLs and ACs. A loss in proprioception could be a local risk factor in OA. The proprioceptive impact of preserving PCL while performing total knee arthroplasty may not be exaggerated as its thought.
Prognostic study, Level I.
膝关节本体感觉准确性受损被认为是膝骨关节炎发病和进展的局部因素。机械感受器数量减少的患者由于关节本体感觉丧失，更有可能发生关节炎。我们旨在确定和量化膝关节骨关节炎中后交叉韧带（PCL）、前囊（AC）和内侧半月板囊结合部（MCJ）的机械感受器。
从 30 例 Kellgren 和 Lawrence 分级 3 和 4 级骨关节炎（OA）患者中采集 PCL、AC 和 MCJ，从 5 例无 OA 的尸体中采集 10 个膝关节作为对照组。用苏木精和伊红评估 PCL 退变，用 S100 免疫染色评估机械感受器的类型和数量。
OA 组和对照组患者的年龄无差异（n.s.）。与对照组相比，OA 组的 PCL 退变更严重（p=0.04）。OA 组的 PCL 高尔基小体、Ruffini 小体、游离神经末梢、总神经末梢和小血管数量较少，AC 的高尔基小体、游离神经末梢和总神经末梢数量也较少。两组间 MCJ 的机械感受器无明显相关性。
OA 患者的 PCL 和 AC 机械感受器数量减少。本体感觉丧失可能是 OA 的局部危险因素。在进行全膝关节置换术时保留 PCL 的本体感觉影响可能不会像人们想象的那样夸大。
预后研究，I 级。
