Mizuno Yushin, Takata Yasushi, Yoshioka Kazuaki, Demura Satoru, Nakase Junsuke
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, JPN.
Section of Rehabilitation, Kanazawa University Hospital, Kanazawa, JPN.
Cureus. 2024 May 29;16(5):e61324. doi: 10.7759/cureus.61324. eCollection 2024 May.
Graft failure is a common postoperative complication after anterior cruciate ligament (ACL) reconstruction. Recently, a theory has emerged that histological and microstructural factors of autografts may be related to graft failure. We simultaneously collected the semitendinosus tendon (ST), quadriceps tendon (QT), and patellar tendon (PT) from a 22-year-old patient to provide insights into the differences in the collagen-type composition of the three tendons in skeletally mature patients. These findings may serve as a basis for selecting autografts for ACL to reduce graft failure rates. The patient was a 22-year-old female who required the removal of artificial ligament, screws, and washers and medial patellofemoral ligament (MPFL) reconstruction with an ST autograft after two surgeries for recurrent dislocation of the left patella. The ST, QT, and PT obtained during necessary intraoperative procedures were used as samples. The tissues were processed and immunostained; this was followed by confocal microscopy. Evaluation was performed by calculating the percentage of areas positive for collagen types I and III.The percentage of type I collagen in the ST, QT, and PT groups was 88%, 85%, and 88%, respectively.The collagen-type composition was examined following simultaneous collection of the ST, QT, and PT. The results revealed no significant differences in the content of physically strong type I collagen, which supports previous findings showing that the clinical outcomes after ACL reconstruction do not vary with the autograft used.
移植物失败是前交叉韧带（ACL）重建术后常见的并发症。最近，一种理论认为自体移植物的组织学和微观结构因素可能与移植物失败有关。我们从一名22岁患者身上同时采集了半腱肌肌腱（ST）、股四头肌肌腱（QT）和髌腱（PT），以深入了解骨骼成熟患者这三种肌腱胶原类型组成的差异。这些发现可为选择ACL自体移植物以降低移植物失败率提供依据。该患者为22岁女性，因左髌骨反复脱位接受了两次手术后，需要取出人工韧带、螺钉和垫圈，并使用ST自体移植物进行内侧髌股韧带（MPFL）重建。术中必要操作过程中获取的ST、QT和PT用作样本。对组织进行处理和免疫染色，随后进行共聚焦显微镜检查。通过计算I型和III型胶原阳性区域的百分比进行评估。ST组、QT组和PT组中I型胶原的百分比分别为88%、85%和88%。在同时采集ST、QT和PT后检查胶原类型组成。结果显示，物理强度较高的I型胶原含量无显著差异，这支持了先前的研究结果，即ACL重建后的临床结果不会因使用的自体移植物不同而有所差异。
