Characterisation of morphology in musculus semitendinosus tendon used for anterior cruciate ligament reconstruction: a pilot study
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Priekšējās krusteniskās saites ruptūra ir ļoti izplatīta atlētu vidū. Vispārējā populācijā incidence ir aptuveni 33 gadījumi uz 100 000 iedzīvotāju.
Pētījuma mērķis. Pētījuma mērķis bija izvērtēt morfoloģiskās izmaiņas musculus semitendinosus cīpslā, kuru izmanto priekšējās krusteniskās saites rekonstrukcijā, lai saprastu kvalitāti visbiežāk šajās operācijās izmantotajā materiālā.
Materiāli un metodes. Izpētes materiāls tika iegūts no četrām autologām priekšējās krusteniskās saites rekonstruktīvām operācijām. Audi tika iekrāsoti ar hematoksilīnu un eozīnu, kā arī ar imūnhistoķīmisku krāsojumu, kas iekrāso PGP9.5, VEGF, I un III tipa kolagēnu. Materiāli tika analizēti ar semikvantitatīvu metodi.
Rezultāti. Krāsojumā ar hematoksilīnu un eozīnu novēro praktiski neizmainītas cīpslas struktūras ar vienu izņēmumu, kad vienā paraugā novēro sklerotisku asinsvadu endotenon daļā. III tipa kolagēna imūnhistoķīmiskā krāsojumā vidēji līdz daudz pozitīvas kolagēna šķiedras vērojamas divos gadījumos, bet abos pārējos gadījumos pozitīvās struktūras ir reti redzamas. I tipa kolagēna imūnhistoķīmiskā krāsojumā reti līdz vidēji bieži vērojamas pozitīvas kolagēna šķiedras visos četros preparātos. Divos gadījumos novērojams vidējs daudzums PGP9.5 iekrāsotu nervu šķiedru, tomēr divos pārējos gadījumos PGP9.5 iekrāsotās nervu šķiedras vērojamas ļoti reti līdz reti. PGP9.5 iezīmēja augstāku nervu šķiedru skaitu peritenon nekā endotenon daļā. Daudzi VEGF pozitīvi endoteliocīti tika novēroti divos gadījumos, kamēr 2 pārējos gadījumos VEGF pozitīvi endoteliocīti bija vērojami ļoti reti.
Secinājumi. Novērojami 2 dažādi veidi, kā musculus semitendinosus cīpslā sadalās audu išēmijas pazīmes, neiropeptīdu saturošā inervācija, I un III tipa kolagēna šķiedru daudzums. Domājams, ka III tipa kolagēna šķiedras vērtējamas kā atbilde uz cīpslas iepriekšēju išēmiju ar intensīvu inervāciju, kamēr paaugstināts I tipa kolagēna šķiedru daudzums iespējams ir saistīts ar relatīvi nemainītu vaskulatūru un inervāciju. Veids kāds novērojams musculus semitendinosus cīpslā varētu būt saistīts ar indivīda homeostāzi pacientiem pirms cīpslas lietošanas rekonstruktīvām procedūrām.
Introduction. Anterior cruciate ligament (ACL) rupture is very common in athletes. In general population incidence is approximately 33 per 100 000 people. Aim of the study. The aim of the study was the evaluation of morphological changes in the musculus semitendinosus tendon used for the reconstruction of ACL to understand quality of most common for surgery used material. Material and methods. The materials were obtained from four ACL autologous hamstring reconstruction surgeries. Tissue were stained with hematoxyllin and eosin and with immunohistochemical (IMH) staining of PGP9.5, VEGF, collagen I and collagen III. The material was evaluated with semiquantitative method. Results. Routine staining showed practically unchanged tendon structure, with one exception when sclerotic blood vessels were observed in endotenon. Collagen III IMH demonstrated moderate to numerous positive collagen fibres in two cases, but in other two there were only few positive structures seen. Collagen I IMH showed few to moderate number of positive collagen fibres in all cases. In two cases moderate number of PGP9.5 positive nerve fibres was observed and in two other cases occasional to few number of positive structures was detected. PGP 9.5 marked higher number of nerve fibres in peritenon than in endotenon. Numerous VEGF positive endotheliocytes were observed in two cases but in two other cases VEGF positive endotheliocytes were occasional. Conclusions. Tendon of musculus semitendinosus displays two patterns of distribution of tissue ischemia, neuropeptide containing innervation and collagen I and III, where collagen III is thought to be evaluated as a response of tendon to the ischemia and intensive innervation, while increase of collagen I probably is related to the relatively unchanged vascularity and innervation. The pattern of musculus semitendinosus tendon structural changes seems to be connected to the individual homeostasis in patients persisting before the usage of tendon for the reconstruction.
Introduction. Anterior cruciate ligament (ACL) rupture is very common in athletes. In general population incidence is approximately 33 per 100 000 people. Aim of the study. The aim of the study was the evaluation of morphological changes in the musculus semitendinosus tendon used for the reconstruction of ACL to understand quality of most common for surgery used material. Material and methods. The materials were obtained from four ACL autologous hamstring reconstruction surgeries. Tissue were stained with hematoxyllin and eosin and with immunohistochemical (IMH) staining of PGP9.5, VEGF, collagen I and collagen III. The material was evaluated with semiquantitative method. Results. Routine staining showed practically unchanged tendon structure, with one exception when sclerotic blood vessels were observed in endotenon. Collagen III IMH demonstrated moderate to numerous positive collagen fibres in two cases, but in other two there were only few positive structures seen. Collagen I IMH showed few to moderate number of positive collagen fibres in all cases. In two cases moderate number of PGP9.5 positive nerve fibres was observed and in two other cases occasional to few number of positive structures was detected. PGP 9.5 marked higher number of nerve fibres in peritenon than in endotenon. Numerous VEGF positive endotheliocytes were observed in two cases but in two other cases VEGF positive endotheliocytes were occasional. Conclusions. Tendon of musculus semitendinosus displays two patterns of distribution of tissue ischemia, neuropeptide containing innervation and collagen I and III, where collagen III is thought to be evaluated as a response of tendon to the ischemia and intensive innervation, while increase of collagen I probably is related to the relatively unchanged vascularity and innervation. The pattern of musculus semitendinosus tendon structural changes seems to be connected to the individual homeostasis in patients persisting before the usage of tendon for the reconstruction.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Priekšējā krusteniskā saite, ortopēdiskā ķirurģija, musculus semitendinosus, cīpsla, audu faktori, Anterior cruciate ligament (ACL), orthopaedic surgery, musculus semitendinosus, tendon, tissue factors