title: Histological and ultrastructural evaluation of Leeds-Keio ligament 20 years after implant: a case report.
abstract: We were capable of undertaking a histological and ultrastructural evaluation of an intact Leeds-Keio ligament implanted 20 years ago to assess the neoligamentization process inside this artificial ligament. The histological evaluation disclosed a collagen fibrils orientation very close to the structure of a normal anterior cruciate ligament (ACL) where the collagen fibres are multidirectional [Strocchi et al. in J Anat 180(3):515-519, 1992]. On the other hand we found an unimodal distribution of collagen fibrils in the reconstructed ACL. This suggests that even at long-term follow-up stress exerts a variable influence. The multidirectional arrangement of collagen fibres resembles a normal ACL, but the unimodal distribution of fibrils is quite different from those seen in normal tendon and ligaments which tend to have a bimodal peak [Decker et al. in J Submicrosc Cytol Pathol 23:9-21, 1991; Strocchi et al. in J Anat 180(3):515-519, 1992]. Studies based on biopsy suffer from the potential weakness that the specimen may not have been representative of the entire prosthesis. Further long-term studies, possibly with the entire prosthesis and not only a biopsy, would highlight the behaviour and remodelling of this artificial ligament in greater detail and could be important for the development of future generations of artificial ligaments or tissue engineering ACL reconstruction.
authors.affiliation: Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, via di Barbiano, 1/10, 40100, Bologna, Italy. s.zaffagnini@biomec.ior.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.forename: Giulio Maria
authors.initials: GM
authors.lastname: Marcheggiani Muccioli
authors.forename: Vikram
authors.initials: V
authors.lastname: Chatrath
authors.forename: Alice
authors.initials: A
authors.lastname: Bondi
authors.forename: Viviana
authors.initials: V
authors.lastname: De Pasquale
authors.forename: Desiree
authors.initials: D
authors.lastname: Martini
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bacchelli
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D001182:Arthroscopy; D003094:Collagen / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007718:Knee Injuries / Q000473:pathology / Q000601:surgery; D008023:Ligaments, Articular; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D023822:Tissue Engineering; D054457:Tissue Scaffolds
chemical_list: D003094:Collagen
references.citation: J Anat. 1992 Jun;180 ( Pt 3):515-9
references.pmid: 1487443
references.citation: Knee Surg Sports Traumatol Arthrosc. 1997;5(2):89-94
references.pmid: 9228315
references.citation: Knee. 2004 Feb;11(1):9-14
references.pmid: 14967321
references.citation: J Bone Joint Surg Br. 1989 Aug;71(4):566-70
references.pmid: 2768298
references.citation: Knee Surg Sports Traumatol Arthrosc. 1996;4(1):9-13
references.pmid: 8819057
references.citation: J Bone Joint Surg Br. 1991 May;73(3):377-80
references.pmid: 1670431
references.citation: Clin Orthop Relat Res. 1985 Jun;(196):186-95
references.pmid: 3888466
references.citation: J Clin Pathol. 1994 Apr;47(4):375-6
references.pmid: 8027382
references.citation: Arthroscopy. 1998 Mar;14(2):197-205
references.pmid: 9531133
references.citation: Orthopade. 1999 Jan;28(1):26-32
references.pmid: 10081041
references.citation: Am J Sports Med. 2005 Aug;33(8):1166-73
references.pmid: 16000668
references.citation: Am J Sports Med. 1993 May-Jun;21(3):367-73
references.pmid: 8346749
references.citation: J Orthop Res. 1986;4(2):162-72
references.pmid: 3712125
references.citation: Knee Surg Sports Traumatol Arthrosc. 1994;2(4):214-8
references.pmid: 8536043
references.citation: J Bone Joint Surg Br. 1984 Nov;66(5):672-81
references.pmid: 6501359
references.citation: Am J Sports Med. 1988 Nov-Dec;16(6):558-70
references.pmid: 2853576
references.citation: Arthroscopy. 1993;9(4):387-93
references.pmid: 8216569
references.citation: Clin Anat. 2003 Jan;16(1):19-24
references.pmid: 12486734
references.citation: Clin Orthop Relat Res. 1991 Jun;(267):115-21
references.pmid: 1828400
references.citation: Biomaterials. 2005 May;26(15):2663-70
references.pmid: 15585269
references.citation: J Submicrosc Cytol Pathol. 1991 Jan;23(1):9-21
references.pmid: 2036629
references.citation: J Bone Joint Surg Am. 1982 Feb;64(2):217-24
references.pmid: 7056776
references.citation: J Bone Joint Surg Br. 1994 Mar;76(2):193-7
references.pmid: 8113274
references.citation: Knee Surg Sports Traumatol Arthrosc. 1993;1(2):71-5
references.pmid: 8536011