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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Mechanoreceptor Re-innervation Following Allograft versus Autograft Anterior Cruciate Ligament Reconstruction
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Mechanoreceptor Re-innervation Following Allograft versus Autograft Anterior Cruciate Ligament Reconstruction

机译：同种异体移植与自体移植前交叉韧带重建后的机械感受器再支配

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Objectives: Functional instability following anterior cruciate ligament (ACL) rupture is due to both loss of mechanical restraint, and loss of proprioception that restricts the ability of coordinated muscle activity to compensate and stabilize the knee joint. This lack of coordinated muscle control is thought to be due to diminished or absent sensory feedback from the ACL mechanoreceptors to the neuromuscular system. Clinical, motor and proprioceptive function is known to improve following ACL reconstruction but does not return to normal. While histological studies of human ACL allografts have been unable to demonstrate mechanoreceptor re-innervation, animal data suggests re-innervation occurs when an autograft is used. The aim of this study was to compare the presence or absence of mechanoreceptors in allograft versus autograft in following ACL reconstruction in humans. Methods: Eleven patients with previous ACL reconstruction presenting for either revision ACL surgery or knee arthroscopy for other reasons were enrolled in a prospective, comparative study. Six patients had a previous autograft ACL and five patients had an allograft. In the case of revision patients, the previous ACL graft tissue was excised within 6 weeks of ligament rupture, and in arthroscopy patients 2mm biopsies of the ACL graft were taken from the tibial and femoral insertions. ACL tissue was also taken from 2 additional patients within 6 weeks following acute primary ACL rupture as a control. The specimens were fixed with 10% buffered formalin solution and frozen section was performed. Specimens were stained with hematoxylin-eosin (H-E) and monoclonal antibodies against S-100 and neurofilament protein (NFP). Immunohistochemical examination was performed using Freeman and Wyke's criteria to morphologically classify mechanoreceptors. Results: Ruffini corpuscles and free nerve endings were shown to be present in the specimens of the control group. Histological examination for mechanoreceptors for six patients with previous autografts and five patients with previous allografts were compared. The average time between original graft and biopsy was 10.7 years (range 0.5 ### 27). There were significantly more mechanoreceptors visible in control (native) ACL tissue than graft tissue. Conclusion: We present comparative data demonstrating reduced concentration of mechanoreceptors in ACL grafts compared to native ACL tissue. This may explain the continued proprioceptive deficit known to exist even following ACL reconstruction.
机译：目的：前十字韧带（ACL）断裂后的功能不稳定是由于机械约束的丧失和本体感觉的丧失，本体感觉的丧失限制了协调的肌肉活动来补偿和稳定膝关节的能力。这种缺乏协调的肌肉控制被认为是由于从ACL机械感受器到神经肌肉系统的感觉反馈减弱或缺乏。重建ACL后，临床，运动和本体感受功能会改善，但不会恢复正常。尽管对人类ACL同种异体移植的组织学研究无法证明机械受体重新神经支配，但动物数据表明，使用自体移植后会再次神经支配。这项研究的目的是比较在人类ACL重建后同种异体移植与自体移植中是否存在机械感受器。方法：11例因其他原因而进行了ACL修订手术或膝关节镜检查的先前ACL重建的患者参加了一项前瞻性比较研究。 6例患者曾接受过自体移植ACL，5例患者接受了同种异体移植。对于翻修患者，在韧带破裂后的6周内切除先前的ACL移植组织，在关节镜检查患者中，从胫骨和股骨插入物中取出2mm的ACL移植活检。急性原发性ACL破裂后6周内还从另外2名患者中取出ACL组织作为对照。标本用10％福尔马林缓冲溶液固定并进行冷冻切片。标本用苏木精-曙红（H-E）和针对S-100和神经丝蛋白（NFP）的单克隆抗体染色。免疫组织化学检查采用Freeman和Wyke的标准对机械感受器进行形态分类。结果：对照组标本中存在Ruffini小球和自由神经末梢。比较了6例先前自体移植和5例先前同种异体移植的机械感受器的组织学检查。最初的移植和活检之间的平均时间为10.7年（范围为0.5 ### 27）。对照（天然）ACL组织中可见的机械感受器明显多于移植组织。结论：我们目前的比较数据表明，与天然ACL组织相比，ACL移植物中机械感受器的浓度降低了。这可以解释即使在ACL重建后仍存在的持续的本体感觉缺陷。

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