Department of Orthopedic Surgery, Hankook Hospital, Mokpo, Republic of Korea.
Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, Republic of Korea.
Am J Sports Med. 2020 Oct;48(12):3013-3020. doi: 10.1177/0363546520950764. Epub 2020 Sep 10.
Mechanoreceptor is a subtype of somatosensory receptor. It conveys extracellular stimuli through intracellular signal conduction via mechanically gated ion channel. It conveys not only kinetic stimuli but also pressure, stretching, touch, and even sound wave. Few studies have determined whether mechanoreceptors are present in Achilles tendon allografts used during remnant-preserving posterior cruciate ligament (PCL) reconstruction (PCLR).
PURPOSE/HYPOTHESIS: The purpose was to investigate whether mechanoreceptors are present in remnant tissues of the PCL and allograft tissues after PCLR. It was hypothesized that mechanoreceptors may be present in the remnant PCL tissue of the patients who underwent remnant PCLR technique.
Controlled laboratory study.
Tissue samples were obtained from 14 participants who had undergone PCLR by means of Achilles tendon allografts (PCLR group) and from 4 healthy controls (control group). Among the PCLR group, 12 patients had undergone a remnant PCLR technique and the remaining 2 patients had undergone a nonremnant PCLR technique. In the PCLR group, we obtained samples during second-look arthroscopy or total knee arthroplasty after PCLR. In the control group, 4 biopsy specimens of normal PCL tissues were obtained from patients who had undergone other arthroscopic procedures. To check the presence of mechanoreceptors, immunohistochemical studies were performed on all biopsy specimens to identify neuronal and neurocytic markers by using monoclonal antibodies against glial fibrillary acidic protein, neuron-specific enolase, neurofilament, and S-100 protein. Only 1 of these markers needed to be positive to prove the presence of mechanoreceptors.
Neural tissue analogs, confirmed to be mechanoreceptors with monoclonal antibodies by the Ultraview DAB detection kit, were found in all specimens obtained from the control group. Mechanoreceptors were not found in the allograft specimens. However, remnant PCL tissues were found to have mechanoreceptors in 11 of 12 samples (91.7%).
The results demonstrate that Achilles tendon allografts lack mechanoreceptors. This study can be used as histological evidence to support the advantage of remnant-preserving techniques for PCLR because they preserve proprioception.
To preserve proprioception, which leads to better functional outcome, using the remnant technique is a better procedure for PCL reconstruction.
机械感受器是躯体感觉感受器的一种亚型。它通过机械门控离子通道在细胞内信号传导中传递细胞外刺激。它不仅传递动力刺激，还传递压力、拉伸、触摸，甚至声波。很少有研究确定在保留后交叉韧带（PCL）重建（PCLR）中使用的同种异体跟腱移植物中是否存在机械感受器。
目的/假设：目的是研究在 PCLR 后，PCL 的残端组织和同种异体组织中是否存在机械感受器。假设在接受保留 PCLR 技术的患者的残留 PCL 组织中可能存在机械感受器。
对照实验室研究。
从接受同种异体跟腱 PCLR（PCLR 组）的 14 名参与者和 4 名健康对照者（对照组）中获得组织样本。在 PCLR 组中，12 名患者接受了保留 PCLR 技术，其余 2 名患者接受了非保留 PCLR 技术。在 PCLR 组中，我们在 PCLR 后的关节镜检查或全膝关节置换术中获得样本。在对照组中，从接受其他关节镜手术的患者中获得 4 个正常 PCL 组织的活检标本。为了检查机械感受器的存在，我们对所有活检标本进行免疫组织化学研究，使用针对神经胶质纤维酸性蛋白、神经元特异性烯醇化酶、神经丝和 S-100 蛋白的单克隆抗体来识别神经元和神经细胞标记物。只有 1 种标记物阳性即可证明机械感受器的存在。
用 Ultraview DAB 检测试剂盒用单克隆抗体证实的神经组织类似物在对照组获得的所有标本中均被证实为机械感受器。同种异体移植物标本中未发现机械感受器。然而，在 12 个样本中的 11 个（91.7%）中发现了残留 PCL 组织中的机械感受器。
结果表明，跟腱同种异体移植物缺乏机械感受器。这项研究可以作为组织学证据，支持保留 PCLR 技术的优势，因为它们保留了本体感觉。
为了保留本体感觉，从而获得更好的功能结果，使用残留技术是 PCL 重建的更好方法。
