Sahu Nabin K, Patro Bishnu P, Tripathy Milan, Nanda Saurav N
Orthopedics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, IND.
Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Cureus. 2024 Sep 1;16(9):e68394. doi: 10.7759/cureus.68394. eCollection 2024 Sep.
Anterior cruciate ligament (ACL) injury is one of the most common sports-related injuries. Because of its intra-capsular location, it has very little chance of healing following injury. The causes of poor healing of ACL tears are mostly due to poor vascularity, disorganized collagen bundles, insufficient myofibroblast proliferation, etc. The healing potential is also varied in different age groups like any other tissue. Here, we studied the histological changes in ACL remnants that occur after ACL injury in different age groups and with varied times of presentation since injury. It was a prospective observational study comparing the histopathology of ACL remnants in 12 subgroups of cases. Healthy synovial lining, presence of inflammatory cells, neo-vascularization, and myofibroblasts are needed for natural healing of ACL. We found a favorable environment for the healing of ACL in younger patients with an injury period of one to three months. We suggest cases with a partial tear of ACL in a young individual presented within one to three months duration may be encouraged for conservative treatment or ACL repair surgery rather than ACL reconstruction. Our initial study on the histopathology of torn ACL has added insight into the existing literature and further studies are needed to substantiate its further application.
前交叉韧带（ACL）损伤是最常见的运动相关损伤之一。由于其位于关节囊内，损伤后愈合的机会非常小。ACL撕裂愈合不良的原因主要是血管供应差、胶原束紊乱、肌成纤维细胞增殖不足等。与其他组织一样，不同年龄组的愈合潜力也有所不同。在此，我们研究了不同年龄组ACL损伤后以及损伤后不同就诊时间的ACL残端的组织学变化。这是一项前瞻性观察性研究，比较了12个病例亚组中ACL残端的组织病理学。ACL自然愈合需要健康的滑膜衬里、炎症细胞的存在、新生血管形成和肌成纤维细胞。我们发现，对于损伤时间为1至3个月的年轻患者，ACL愈合存在有利环境。我们建议，对于年轻个体在1至3个月内出现的ACL部分撕裂病例，可鼓励采取保守治疗或ACL修复手术，而非ACL重建。我们对撕裂的ACL组织病理学的初步研究为现有文献增添了见解，还需要进一步研究来证实其进一步应用。
