Costa Lauro Augusto Veloso, Mestriner Marcos Barbieri, Amaral Thiago Alvim do, Barbosa Bárbara Dos Santos, Kaleka Camila Cohen, Cury Ricardo de Paula Leite
Departamento de Ortopedia e Traumatologia, Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas, São Paulo, SP, Brazil.
Departamento de Anatomia Patológica, Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas, São Paulo, SP, Brazil.
Rev Bras Ortop. 2018 Jun 8;53(4):415-420. doi: 10.1016/j.rboe.2018.05.006. eCollection 2018 Jul-Aug.
To describe the microscopic anatomy of the posterior cruciate ligament femoral insertion in order to identify and establish differences between the direct and indirect insertions of this ligament.
Ten cadaveric knees were used for this study. The posterior cruciate ligament femoral insertion was observed microscopically. Hematoxylin and eosin staining was performed to observe the morphology of the posterior cruciate ligament insertion. Alcian blue staining was performed to determine the location of the cartilage matrix and better assist in the observation and differentiation between direct and indirect insertions.
The direct insertion was observed to be a more complex structure than the indirect insertion because it showed four different histological layers (ligament, uncalcified fibrocartilage, calcified fibrocartilage, and bone). Chondrocytes were observed in the uncalcified and calcified fibrocartilage layers. It was observed that the indirect insertion was composed of two layers in which the ligament was anchored directly to the bone by collagen fibers. Indirect insertion was located in the marginal region of the posterior cruciate ligament between the direct insertion and the anterior articular cartilage.
Through histological analysis, it was demonstrated that the indirect insertion was adjacent to the anterior articular cartilage and presents a histological pattern where the collagen fibers insert directly into the bone (two-layer insertion). The direct insertion is posterior to the indirect insertion and has four histologically distinct layers.
描述后交叉韧带股骨附着点的微观解剖结构，以识别并确定该韧带直接附着和间接附着之间的差异。
本研究使用了10具尸体膝关节。对后交叉韧带股骨附着点进行微观观察。进行苏木精-伊红染色以观察后交叉韧带附着点的形态。进行阿尔辛蓝染色以确定软骨基质的位置，并更好地辅助观察和区分直接附着和间接附着。
观察到直接附着比间接附着结构更复杂，因为它呈现出四个不同的组织学层（韧带、未钙化纤维软骨、钙化纤维软骨和骨）。在未钙化和钙化纤维软骨层中观察到软骨细胞。观察到间接附着由两层组成，其中韧带通过胶原纤维直接附着于骨。间接附着位于后交叉韧带的边缘区域，介于直接附着和前关节软骨之间。
通过组织学分析表明，间接附着毗邻前关节软骨，呈现出胶原纤维直接插入骨内的组织学模式（两层附着）。直接附着位于间接附着的后方，具有四个组织学上不同的层。
