head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2019, vol. 25, issue4
Subject Area: Medicine
DOI: 10.5272/jimab.2019254.2847
Published online: 19 December 2019

Original article

J of IMAB. 2019 Oct-Dec;25(4):2847-2852;
Iskren Gerasimov1,2ORCID logo Corresponding Autoremail, Stefan Trifonov1ORCID logo, Desislava Marinova1ORCID logo, Aleksandar Todorov1ORCID logo, Iliyana Vacheva1ORCID logo, Savelina Popovska3ORCID logo, Asparuh Asparuhov2ORCID logo, Ivan Ivanov3ORCID logo,
1) Department of Anatomy, Cytology, Histology and Biology, Faculty Medicine, Medical University Pleven, Bulgaria.
2) Department of Orthopaedics and Trauma, Faculty Medicine, Medical University Pleven, Bulgaria.
3) Department of Pathology, Faculty Medicine, Medical University Pleven, Bulgaria.

Introduction/Aim: The anterior cruciate ligament (ACL) of the knee joint is one of the most investigated structures of the musculoskeletal system. Numerous studies are dedicated to the macro- and micro anatomy of human and animal ACL, but not many are focused on the proprioceptors of the ligament. The aim of this study was to establish a relationship between the proprioceptors and the stage of degenerative changes in the ACL.
Materials and Methods:  Sixty ACL were harvested from patients admitted for knee replacement surgery. The samples were processed, histochemically and immunohistochemically stained according to standard laboratory protocols. Results were analysed and interpreted. The research was approved by the Ethics Committee of Medical University Pleven.
Results: Fifty-seven patients were included in our study – 37 females and 20 males. The average age of patients was 66.48 years. Degeneration of ACL was classified in four stages, and four different patterns of degeneration were observed: 1) necrosis and inflammation; 2) myxoid and cystic formation; 3) vascularisation with myxoid changes; 4) inflammation and hyalinosis. With the increasing severity of degeneration, the number of specialized nervous structures diminish.
Discussion: Our findings support the results from studies on animal models, conducted by other authors. Cabuk et al. reported a diminishing number of proprioceptors in the PCL of an osteoarthritic human knee.The lower number of proprioceptors could result in the onset or progression of the arthritic process.
Conclusion: Osteoarthritis involves all elements of the knee joint. Altered proprioception could be the reason for unsatisfied patients with artificial knees.

Keywords: ACL, proprioceptors, osteoarthritis,

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Please cite this article as: Gerasimov I, Trifonov S, Marinova D, Todorov A, Vacheva I, Popovska S, Asparuhov A, Ivanov I. Morphological changes in the proprioceptors of human anterior cruciate ligament during degenerative osteoarthritis. J of IMAB. 2019 Oct-Dec;25(4):2847-2852.
DOI: 10.5272/jimab.2019254.2847

Corresponding AutorCorrespondence to: Iskren Gerasimov, Department Anatomy, cytology, histology and biology, Faculty Medicine, Medical University Pleven; 5 Hristo Botev str., Ent, K, ap. 14, Pleven, Bulgaria; E-mail: is.gerasimov@abv.bg

1. Deehan DJ, Cawston TE. The biology of integration of the anterior cruciate ligament. J Bone Joint Surg Br. 2005 Jul;87(7):889-95. [PubMed] [Crossref]
2. Bicer EK, Lustig S, Servien E, Selmi TA, Neyret P. Current knowledge in the anatomy of the human anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2010 Aug;18(8):1075-84. [PubMed] [Crossref]
3. Tantisricharoenkul G, Linden-Rosen M, Araujo P, Zhou J, Smolinski P, Fu F. Anterior cruciate ligament: an anatomical exploration in humans and in a selection of animal species. Knee Surg Sports Traumatol Arthrosc. 2014 May;22(5):961-71. [PubMed] [Crossref]
4. Freeman R, Wyke B. The innervation of the knee joint. An anatomical and histological study in the cat. J. Anat. 1967 Jun;101(Pt 3):505-32. [PubMed]
5. Hagert E. Wrist ligaments—innervation patterns and ligamento-muscular reflexes [Thesis], [Stockholm]: Karolinska Institutet; 2008; 51p.
6. Halata Z. The ultrastructure of the sensory nerve endings in the articular capsule of the knee joint of the domestic cat (Ruffini corpuscles and Pacinian corpuscles). J Anat. 1977 Dec;124(Pt 3):717-29. [PubMed]
7. Cushner FD, La Rosa DF, Vigorita VJ, Scuderi GR, Scott WN, Insall JN. A quantitative histologic comparison: ACL degeneration in the osteoarthritic knee. J Arthroplasty 2003; 18(6):687–92. [Crossref]
Hasegawa A, Nakahara H, Kinoshita M, Asahara H, Koziol J, Lotz MK. Cellular and extracellular matrix changes in anterior cruciate ligaments during human knee aging and osteoarthritis. Arthritis Res Ther. 2013 Feb 14;15(1):R29. [PubMed] [Crossref]
9. Allain J, Goutallier D, Voisin MC. Macroscopic and histological assessments of the cruciate ligaments in arthrosis of the knee. Acta Orthop Scand. 2001 Jun;72(3):266-9. [PubMed] [Crossref]
10. Han J, Waddington G, Adams R, Anson J, Liu Y. Assessing proprioception: A critical review of methods. J Sport Health Sci. 2016 Mar;5(1):80-90. [PubMed] [Crossref]
11. Dhillon MS, Bali K, Vasistha RK. Immunohistological evaluation of proprioceptive potential of the residual stump of injured anterior cruciate ligaments (ACL). Int Orthop. 2010 Jun;34(5):737-41. [PubMed] [Crossref]
12. Bali K, Dhillon MS, Vasistha RK, Kakkar N, Chana R, Prabhakar S. Efficacy of immunohistological methods in detecting functionally viable mechanoreceptors in the remnant stumps of injured anterior cruciate ligaments and its clinical importance. Knee Surg Sports Traumatol Arthrosc. 2012 Jan;20(1):75-80. [PubMed] [Crossref]
13. Lee BI, Min KD, Choi HS, Kwon SW, Chun DI, Yun ES, et al. Immunohistochemical study of mechanoreceptors in the tibial remnant of the ruptured anterior cruciate ligament in human knees. Knee Surg Sports Traumatol Arthrosc. 2009 Sep;17(9):1095-101 [PubMed] [Crossref]
14. Sonnery-Cottet B, Bazille C, Hulet C, Colombet P, Cucurulo T, Panniset JC, et al. Histological features of the ACL remnant in partial tears. Knee. 2014  Dec;21(6):1009-13. [PubMed] [CrossRef]
15. Aydoğ ST, Korkusuz P, Doral MN, Tetik O, Demirel HA. Decrease in the numbers of mechanoreceptors in rabbit ACL: the effects of aging.Knee Surg Sports Traumatol Arthrosc. 2006 Apr;14(4):325-9. [PubMed] [Crossref]
16. Çabuk H, Çabuk F, Tekin AC, Dedeoglu SS, Cakar M, Buyukkurt CD. Lower numbers of mechanoreceptors in the posterior cruciate ligament and anterior capsule of the osteoarthritic knees. Knee Surg Sports Traumatol Arthrosc. 2017 Oct;25(10):3146-3154. [PubMed] [CrossRef]
17. Chun KC, Lee SH, Kim JW, Jin EJ, Kim KM, Chun CH. Immunohistochemical and immunocytochemical study of mechanoreceptors in anterior cruciate ligament reconstruction with the remnant-preserving technique using Achilles tendon allografts. J Orthop Surg Res. 2017 Jun 14;12(1):93. [PubMed] [Crossref].

Received: 22 March 2019
Published online: 19 December 2019

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