Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, 110049.
Department of Anatomy, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, 110029.
Surg Radiol Anat. 2021 Oct;43(10):1659-1666. doi: 10.1007/s00276-021-02757-y. Epub 2021 Apr 28.
We have consistently observed a connective tissue lining over the intercondylar notch's roof (CTLINR) during arthroscopic surgeries of the knee joint. As there is a strong association of the intercondylar fossa with the anterior cruciate ligament (ACL), we believe that this tissue must be having some role in the functioning of the ACL. The purpose of this pilot study was to investigate the anatomic characteristics of the CTLINR.
In this observational anatomical study, we have investigated the gross anatomical and histological features of the CTLINR in four knees of two fresh frozen non-embalmed cadavers. We have also studied its ultrastructural characteristics by obtaining an arthroscopic biopsy of the tissue from a patient undergoing ACL reconstruction.
At gross examination, the CTLINR had a typical glistening white surface with transversely oriented fibres. It entirely covered the roof of the intercondylar notch and was soft to touch. Histological examination with haematoxylin-eosin stain revealed fibro-collagenous tissue with intervening blood vessels. Transmission electron microscopy manifested loosely arranged collagen fibres of variable diameter.
The histological and electron microscopic characteristics of the tissue differentiate it from the ACL and its femoral enthesis, suggesting that it was a distinct anatomical structure. As it entirely covered the roof of the intercondylar fossa and had a smooth surface and soft consistency, it may protect the reconstructed ACL from graft abrasion. Furthermore, as it had a characteristic arthroscopic appearance, future research can investigate its role in femoral tunnel positioning.
我们在膝关节关节镜手术中始终观察到髁间窝顶部有一层连接组织衬里（CTLINR）。由于髁间窝与前交叉韧带（ACL）有很强的关联，我们认为该组织在 ACL 的功能中必定具有一定的作用。本初步研究的目的是研究 CTLINR 的解剖学特征。
在这项观察性解剖研究中，我们研究了两个未经防腐处理的新鲜冷冻尸体的四个膝关节的 CTLINR 的大体解剖和组织学特征。我们还通过从接受 ACL 重建的患者处获取关节镜活检来研究其超微结构特征。
大体检查时，CTLINR 具有典型的有光泽的白色表面和横向纤维。它完全覆盖髁间窝的顶部，触感柔软。苏木精-伊红染色的组织学检查显示出纤维胶原组织，其间有血管。透射电子显微镜显示出排列松散的不同直径的胶原纤维。
组织的组织学和电子显微镜特征使其与 ACL 和其股骨附着点区分开来，表明它是一种独特的解剖结构。由于它完全覆盖了髁间窝的顶部，表面光滑且质地柔软，因此它可能可以保护重建的 ACL 免受移植物磨损。此外，由于它具有典型的关节镜外观，未来的研究可以研究其在股骨隧道定位中的作用。
