Ultrastructural assessment of the anterolateral ligament
ESSKA Academy. Redler A. 11/08/19; 285252; epESMA-51 Topic: Anatomy
Dr. Andrea Redler
Dr. Andrea Redler
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Abstract
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Introduction: Recent investigations into the anterolateral ligament (ALL) of the knee have provided a renewed focus on these anterolateral structures and their contribution to knee stability and correlation with the pivot-shift test. Despite the plethora of anatomical and biomechanical investigations, microscopic evaluation of the ALL has been limited.
Objectives: The anterolateral ligament (ALL) has been identified as a structure on the lateral side of the knee, but debate exists as to whether it is a capsular thickening or ligamentAims: The purpose of the present studywas to provide a detailed ultrastructural characterization of the ALL and its ultrastructure collagen arrangement using the light microscopy (LM), the transmission electron microscopy (TEM) and variable pressure scanning electron microscopy (VP-SEM).
Methods: Eight paired samples from four fresh-frozen males cadavers were used for the study. Samples were harvested from the ALL, the joint capsuleand the medial collateral ligament (MCL). All samples were evaluated using LM, TEM and VP-SEM. Using LM, the three different tissues were analyzed and morphology described. Using TEM, the morphology and collagen characteristics were quantified and compared between the structures. The three-dimensional characteristics of the structure were then compared on VP-SEM.
Results: Ultrastructure analysis demonstrated similar morphology between the ALL and MCL, with significant differences in these two structures compared to the joint capsule. On LM, both the ALL and MCL were characterized by the presence of a dense collagen fiber oriented in longitudinal and transversal directions of the fiber bundles while the joint capsule was found to have a more disorganized architecture. On TEM the collagen fibers of ALL and MCL demonstrated similar ultrastructural morphology, with both having collagen fibers in parallel, longitudinal alignment. A quantitative analysis was also performed, with the average diameter of fibrils in the ALL being 80 ± 2,66 nm and 150 ± 3,35 nm (all p-values < 0.001) in the MCL. The VP-SEM highlighted that ALL and MCL morphology demonstrated arrangements of fiber bundles that are densely packed and organized, in contrast to the disorganized fibers of the joint capsule.
Conclusions: The ALL and MCL have comparable properties that are distinctly different than the joint capsule as visualized on LM, TEM, and VP-SEM.
Introduction: Recent investigations into the anterolateral ligament (ALL) of the knee have provided a renewed focus on these anterolateral structures and their contribution to knee stability and correlation with the pivot-shift test. Despite the plethora of anatomical and biomechanical investigations, microscopic evaluation of the ALL has been limited.
Objectives: The anterolateral ligament (ALL) has been identified as a structure on the lateral side of the knee, but debate exists as to whether it is a capsular thickening or ligamentAims: The purpose of the present studywas to provide a detailed ultrastructural characterization of the ALL and its ultrastructure collagen arrangement using the light microscopy (LM), the transmission electron microscopy (TEM) and variable pressure scanning electron microscopy (VP-SEM).
Methods: Eight paired samples from four fresh-frozen males cadavers were used for the study. Samples were harvested from the ALL, the joint capsuleand the medial collateral ligament (MCL). All samples were evaluated using LM, TEM and VP-SEM. Using LM, the three different tissues were analyzed and morphology described. Using TEM, the morphology and collagen characteristics were quantified and compared between the structures. The three-dimensional characteristics of the structure were then compared on VP-SEM.
Results: Ultrastructure analysis demonstrated similar morphology between the ALL and MCL, with significant differences in these two structures compared to the joint capsule. On LM, both the ALL and MCL were characterized by the presence of a dense collagen fiber oriented in longitudinal and transversal directions of the fiber bundles while the joint capsule was found to have a more disorganized architecture. On TEM the collagen fibers of ALL and MCL demonstrated similar ultrastructural morphology, with both having collagen fibers in parallel, longitudinal alignment. A quantitative analysis was also performed, with the average diameter of fibrils in the ALL being 80 ± 2,66 nm and 150 ± 3,35 nm (all p-values < 0.001) in the MCL. The VP-SEM highlighted that ALL and MCL morphology demonstrated arrangements of fiber bundles that are densely packed and organized, in contrast to the disorganized fibers of the joint capsule.
Conclusions: The ALL and MCL have comparable properties that are distinctly different than the joint capsule as visualized on LM, TEM, and VP-SEM.
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