Abe S, Kurosaka M, Iguchi T, Yoshiya S, Hirohata K
Department of Orthopaedic Surgery, Kobe University School of Medicine, Japan.
Arthroscopy. 1993;9(4):394-405. doi: 10.1016/s0749-8063(05)80313-5.
We evaluated the remodeling process of autogenous patellar tendon graft for anterior cruciate ligament (ACL) reconstruction by means of light microscopic (LM) and electron microscopic (EM) examinations from the biopsy specimens obtained at the time of second-look arthroscopy. Twenty-one patients were examined at various times postoperatively (from 6 weeks to 15 months, mean 9.5 months), and the results were correlated with the morphology of normal patellar tendon and normal ACL. Our study showed that the graft was revascularized in the early postoperative period, fibroblastic remodeling took place, and the graft obtained gross similarity to the original ACL on their arthroscopic and LM appearances at approximately 1 year postoperatively. However, EM study showed that at both approximately 6 months and 1 year postoperatively the grafts consisted equally of active fibroblasts with a higher cytoplasm-to-nucleus ratio compared with normal ACL. Collagen fibrils of these grafts were of uniformly small diameter compared with normal patellar tendon and ACL. Our results with ultrastructural study suggest that the grafts were still immature even at 1 year postoperatively.
我们通过对二次关节镜检查时获取的活检标本进行光学显微镜（LM）和电子显微镜（EM）检查，评估了自体髌腱移植重建前交叉韧带（ACL）的重塑过程。对21例患者在术后不同时间（从6周至15个月，平均9.5个月）进行了检查，并将结果与正常髌腱和正常ACL的形态进行了对比。我们的研究表明，移植组织在术后早期实现了血管再生，发生了成纤维细胞重塑，并且在术后约1年时，移植组织在关节镜和光学显微镜下的外观与原始ACL大致相似。然而，电子显微镜研究显示，在术后约6个月和1年时，移植组织均由活跃的成纤维细胞组成，与正常ACL相比，其细胞质与细胞核的比例更高。与正常髌腱和ACL相比，这些移植组织的胶原纤维直径均一且较小。我们的超微结构研究结果表明，即使在术后1年，移植组织仍不成熟。
