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ACL Degeneration Study: Pre-Rupture Insights

This study aims to investigate potential degenerative processes in the ACL before rupture through biopsy and histopathological analysis. Understanding these changes could provide valuable insights into the predisposition to ACL injuries.

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ACL Degeneration Study: Pre-Rupture Insights

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  1. Is the ACL degenerated before rupture? John Magne Hoseth, M.D. Kristiansund Hospital

  2. ACL injuries • Incidence - approximately 1 per 3000 individuals • Predominantly in a young and sports-active population • Five times higher in females. • Rate of posttraumatic osteoarthritis is unchanged after ACL reconstruction (Maguire et al 09)

  3. Tendon vs Ligament • Almost identical anatomy • Collagen fiber bundles arranged into fascicles, with variable amounts of elastic fibers (Wheater`s 93) • ACL – biomechanically acts the same way as tendons

  4. Degeneration in tendons • Chronic degenerative changes in tendons predispose to rupture (Kannus et al 91) • Eccentric excercise increases synthesis of type I collagen in achilles tendinosis (Langberg et al 05)

  5. Aims of study To examine whether there is an underlying degenerative process in the ACL prior to rupture

  6. Methods • Biopsy study • Histopathological analysis

  7. Biopsy study • By explorative arthroscopy within 24 hours on patients presenting with traumatic hemarthrosis • Reduces arthrofibrosis • Shortens rehabilitation time before a possible reconstructive procedure • Removal of the ACL if ruptured

  8. Histopathology • Samples are fixed in 70 % ethanol, dehydrated and paraffin embedded • Investigation of angiofibroblastic change. A reparative process that is a strong indicator of chronic degeneration • Apoptosis starts immediately after ACL rupture • Uncertain if findings related to apoptosis can be attributed to pre-rupture ( A. Scott )

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