Chen Jinlong, Chen Shirong
Orthopedic and Joint Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Orthop J Sports Med. 2023 Jun 9;11(6):23259671231168894. doi: 10.1177/23259671231168894. eCollection 2023 Jun.
BACKGROUND: Mechanoreceptors in the posterior cruciate ligament (PCL) can produce proprioception, which is an important reason why patients choose cruciate-retaining total knee arthroplasty (TKA). The number of mechanoreceptors in the PCL of patients with knee osteoarthritis (OA) is unknown. PURPOSE: To provide a theoretical basis for estimating the number of mechanoreceptors in the PCL by evaluating the relationship between this number and patient age or OA severity. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: An overall 28 PCLs from patients with knee OA were collected at the time of TKA and grouped according to patient age (group A, 60-69 years [n = 8]; group B, 70-79 years [n = 12]; group C, ≥80 years [n = 8]) and OA based on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (group I, ≤80 [n = 8]; group II, 81-120 [n = 10]; group III, >120 [n = 10]). Hematoxylin and eosin and S-100 immunohistochemical staining were performed on the slices near the tibial attachment of the PCL, and the number of mechanoreceptors in each slice was counted. Multifactor analysis of variance was used to evaluate the relationship between the number of mechanoreceptors and patient age or WOMAC score. RESULTS: The number of mechanoreceptors (mean ± SD) in groups A, B, and C was 24.00 ± 15.19, 30.92 ± 11.41, and 23.38 ± 11.39, respectively, with no significant between-group differences. The number of mechanoreceptors in groups I, II, and III was 43.50 ± 4.99, 25.00 ± 5.27, and 15.20 ± 5.61, with significant differences between groups I and II, groups I and III, and groups II and III ( < .001 for all). CONCLUSION: In patients with knee OA, age had no significant effect on mechanoreceptor count, but the number of mechanoreceptors in the PCL decreased significantly with higher (worse) WOMAC score. These findings suggest that in patients of any age with high WOMAC scores, there may be little value as it relates to knee proprioception in performing a PCL-retaining TKA.
背景:后交叉韧带(PCL)中的机械感受器可产生本体感觉,这是患者选择保留交叉韧带全膝关节置换术(TKA)的一个重要原因。膝骨关节炎(OA)患者PCL中机械感受器的数量尚不清楚。 目的:通过评估该数量与患者年龄或OA严重程度之间的关系,为估计PCL中机械感受器的数量提供理论依据。 研究设计:横断面研究;证据等级,3级。 方法:在TKA时收集了28条来自膝OA患者的PCL,并根据患者年龄(A组,60 - 69岁[n = 8];B组,70 - 79岁[n = 12];C组,≥80岁[n = 8])和基于西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分的OA情况(I组,≤80[n = 8];II组,81 - 120[n = 10];III组,>120[n = 10])进行分组。对PCL胫骨附着处附近的切片进行苏木精 - 伊红染色和S - 100免疫组织化学染色,并计算每张切片中机械感受器的数量。采用多因素方差分析评估机械感受器数量与患者年龄或WOMAC评分之间的关系。 结果:A组、B组和C组中机械感受器的数量(均值±标准差)分别为24.00±15.19、30.92±11.41和23.38±11.39,组间差异无统计学意义。I组、II组和III组中机械感受器的数量分别为43.50±4.99、25.00±5.27和15.20±5.61,I组与II组、I组与III组以及II组与III组之间存在显著差异(均P <.001)。 结论:在膝OA患者中,年龄对机械感受器数量无显著影响,但PCL中机械感受器的数量随WOMAC评分升高(病情加重)而显著减少。这些发现表明,在任何年龄且WOMAC评分高的患者中,保留PCL的TKA在膝关节本体感觉方面可能价值不大。
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