Ultrastructure Study of Anterior Cruciate Ligament of Advanced Osteoarthritis Patient Subjected to Total Knee Replacement Surgery

Background: The Anterior Cruciate ligament (ACL) has the highest percentage of elastic fibers. It is one of the most common affected ligaments in sport injuries. Osteoarthritic patients often present to the clinic with painful ACL. Case Reports: ACLs were collected from two patient and a total of four knees. The composition of ligament as regard the collagen fibrils, collagen organization, density of fibroblasts and blood vessels, and distribution of the collagen type I, III and V fibrils were examined. Results: The ultrastructural cellular features of the tibial stump of the ruptured ACL showed the presence of myofibroblasts. Conclusion: The finding has a potential bearing on the healing capacity of the ruptured stump and on the functional outcome of the remnant-preserving ACL reconstruction. In addition, the fibril diameter range and collagen fibril index were similar to the previous studies despite of the age effect.