Efficacy of immunohistological methods in detecting functionally viable mechanoreceptors in the remnant stumps of injured anterior cruciate ligaments and its clinical importance

Bali, Kamal; Dhillon, Mandeep; Vasistha, R.; Kakkar, Nandita; Chana, Rishi; Prabhakar, Sharad
January 2012
Knee Surgery, Sports Traumatology, Arthroscopy;Jan2012, Vol. 20 Issue 1, p75
Academic Journal
Purpose: Various histological and immunological methods have been used to detect the mechanoreceptors and nerve fibers on the intact ACLs as well as on the remnant stumps. However, some of these methods lack standardization, and the variable thickness of slices used often leads to misinterpretation. The study was based on the hypothesis that immunohistological methods are easier and more reliable means to demonstrate mechanoreceptors in the remnant ACL stumps as compared with the conventional methods. We also attempted to validate the methodology of immunohistology as a means of characterizing functional mechanoreceptors in the residual stump of an injured ACL. Methods: The remnants of the ruptured ACL in 95 patients were harvested during arthroscopic ACL reconstruction and evaluated immunohistologically using hematoxylin and eosin (H&E), and monoclonal antibodies to S-100 and NFP. Multiple sections from each specimen were serially examined by two histologists. Results: The positivity of monoclonal antibody against NFP showed a statistically significant relationship with the presence of morphologically normal mechanoreceptors, whereas the positivity of monoclonal antibody against S-100 showed a statistically significant relationship with the presence of free nerve ending in the residual stump of an injured ACL. Conclusions: Immunological methods are more reliable and easier to use as compared with the conventional methods of histological staining for identifying remnant stumps likely to be of some proprioceptive benefit after an ACL injury. Such an identification might help us preserve certain remnant stumps during ACL reconstruction which might in turn improve the postoperative functional outcomes.


Related Articles

  • Immunohistological Detection of Relaxin Binding to Anterior Cruciate Ligaments. Galey, Stephanie; Konieczko, Elisa M.; Arnold, Christopher A.; Cooney, Timothy E. // Orthopedics;Dec2003, Vol. 26 Issue 12, p1201 

    Relaxin, a member of the insulin-like growth factor family, alters collagen metabolism in fibroblasts. It was hypothesized that relaxin interacts with the anterior cruciate ligament (ACL), contributing to its elasticity. Twelve ACL specimens were collected from reconstruction surgeries,...

  • Immunohistological evaluation of proprioceptive potential of the residual stump of injured anterior cruciate ligaments (ACL). Dhillon, Mandeep S.; Bali, Kamal; Vasistha, R. K. // International Orthopaedics;Jun2010, Vol. 34 Issue 5, p737 

    To evaluate proprioceptive potential in residual remnants, tissue harvested from ruptured ACLs in 63 consecutive patients was examined for evidence of residual proprioceptive fibres using H&E, and monoclonal antibodies to S-100 and NFP (neurofilament protein). Histological examination showed...

  • On the heterogeneity of the femoral enthesis of the human ACL: microscopic anatomy and clinical implications. Beaulieu, Mélanie; Carey, Grace; Schlecht, Stephen; Wojtys, Edward; Ashton-Miller, James // Journal of Experimental Orthopaedics;7/13/2016, Vol. 3 Issue 1, p1 

    Background: Most ruptures of the native anterior cruciate ligament (ACL) and ACL graft occur at, or near, the femoral enthesis, with the posterolateral fibers of the native ligament being especially vulnerable during pivot landings. Characterizing the anatomy of the ACL femoral enthesis may help...

  • Commentary. Musahl, Volker // Journal of Bone & Joint Surgery, American Volume;8/19/2015, Vol. 97 Issue 16, p1373 

    The author comments on the effectiveness of using transtibial technique for anterior cruciate ligament (ACL) reconstruction.

  • Anatomical understanding a necessity in proper long-term ACL reconstruction.  // Orthopedics Today;Jul2011, Vol. 31 Issue 7, p56 

    The article reports on a lecture presented by Freddie H. Fu at the 2011 Annual Meeting of the Arthroscopy Association of North America which emphasized the necessity of a thorough anatomical understanding in properly handling anterior cruciate ligament (ACL) reconstruction.

  • Scientist designs bio-enhanced ACL regeneration bridge scaffold. KIMBALL, ROBERT // Medical Device Daily;3/22/2013, Vol. 17 Issue 56, p1 

    The article discusses the highlights of a roundtable discussion with Martha Murray, winner of the 2013 AAOS Kappa Delta Ann Doner Vaughn Award for innovative research, held during the American Association of Orthopedic Surgeons (AAOS) Annual Meeting. Murray discussed the effort of her team to...

  • CORR Insights®: how useful is MRI in diagnosing isolated bundle ACL injuries? Levy, Bruce; Levy, Bruce A // Clinical Orthopaedics & Related Research;Oct2013, Vol. 471 Issue 10, p3291 

    The author comments on the article ''How Useful is MRI in Diagnosing Isolated Bundle ACL Injuries?'' It mentions that the authors of the article reported the accuracy of magnetic resonance imaging (MRI) for diagnosis of anterior cruciate ligament (ACL) injuries was 25-53 percent. It also...

  • Arthroscopic treatment for tibial “Peel off” tears in anterior cruciate ligament-case report. Ahn, Jin Hwan; Han, Kye Young; Yu, In Sang; Koh, Kyoung Hwan // European Journal of Orthopaedic Surgery & Traumatology;Nov2013 Supplement, Vol. 23 Issue 2, p251 

    Anterior cruciate ligament (ACL) injury was very common, and its reconstruction is one of the most commonly performed orthopaedic surgeries. A standard treatment option for ACL complete rupture in active young patients is debridement of remnant tissue and reconstruction with various types of...

  • Insertion of autologous tendon grafts to the bone: a histological and immunohistochemical study of hamstring and patellar tendon grafts. Petersen, Wolf; Laprell, Heinz // Knee Surgery, Sports Traumatology, Arthroscopy;Jan2000, Vol. 8 Issue 1, p26 

    This study examined the structure of the insertion of autologous tendon grafts used for anterior cruciate ligament reconstruction. Biopsy specimens of the femoral ¶and tibial bone graft interface were obtained at revision surgery in 14 patients (6 with hamstring grafts, 8 with a patella...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics