Histological study of the posterior cruciate ligament femoral insertion

Abstract

ObjectivesTo describe the microscopic anatomy of the posterior cruciate ligament femoral insertion in order to identify and establish differences between the direct and indirect insertions of this ligament.MethodsTen cadaveric knees were used for this study. The posterior cruciate ligament femoral insertion was observed microscopically. Hematoxylin and eosin staining was performed to observe the morphology of the posterior cruciate ligament insertion. Alcian blue staining was performed to determine the location of the cartilage matrix and better assist in the observation and differentiation between direct and indirect insertions.ResultsThe direct insertion was observed to be a more complex structure than the indirect insertion because it showed four different histological layers (ligament, uncalcified fibrocartilage, calcified fibrocartilage, and bone). Chondrocytes were observed in the uncalcified and calcified fibrocartilage layers. It was observed that the indirect insertion was composed of two layers in which the ligament was anchored directly to the bone by collagen fibers. Indirect insertion was located in the marginal region of the posterior cruciate ligament between the direct insertion and the anterior articular cartilage.ConclusionThrough histological analysis, it was demonstrated that the indirect insertion was adjacent to the anterior articular cartilage and presents a histological pattern where the collagen fibers insert directly into the bone (two-layer insertion). The direct insertion is posterior to the indirect insertion and has four histologically distinct layers.

Comparative histomorphological analysis of elbow ligaments and capsule

“…Stained slices were analyzed in transmission and polarization mode, using 20×, 40×, 200×, and 400× magnification. HE staining was used for the qualitative determination of the structure and composition of collagen (Costa et al, 2018; Perumal et al, 2019; Zhang et al, 2018), EvG staining for the occurrence and semiquantitative distribution of elastic fibers (Chan et al, 2007; Sawatsubashi et al, 2010; Sencimen et al, 2009). The anisotropic arrangement of collagen fibers was classified into four types by using polarization microscopy: densely packed parallel, mixed tight and loose parallel, densely interlaced, and mixed tight and loose interlaced (Rein et al, 2015; Rein et al, 2020; Semisch et al, 2016).…”

Sequential Changes in Posterior Tibial Translation After Posterior Cruciate Ligament Reconstruction: Risk Factors for Residual Posterior Sagging

“…For femoral tunnel creation, we cleared the soft tissue, including the remnants of the torn PCL, using a mechanical shaver and visualized the anatomic landmarks for the PCL femoral footprint. 8 Two 2.4-mm k-wires were separately inserted into the center of the AL and PM bundles of the PCL footprints in an inside-out manner with the knee flexed to 100° to 110°. Matching the graft diameter, two 15- to 20-mm sockets were created by overdrilling the k-wires, with diameters of 6.5 to 8.0 mm for the AL tunnel and 5.0 to 6.5 mm for the PM tunnel, respectively.…”

“…For femoral tunnel creation, we cleared the soft tissue, including the remnants of the torn PCL, using a mechanical shaver and visualized the anatomic landmarks for the PCL femoral footprint. 8 Two 2.4-mm k-wires were separately inserted into the center of the AL and PM bundles of the PCL footprints in an inside-out manner with the knee flexed to 100 to 110 . Matching the graft diameter, two 15-to 20-mm sockets Based on the grading system of Shino et al, 38 where 0 ¼ normal; 1 ¼ superficial fibrillation or surface flaking; 2 ¼ fissuring or fibrillation less than one-half the thickness of the articular cartilage; 3 ¼ fasciculation, fragmentation, or degeneration greater than one-half the thickness of the articular cartilage; and 4 ¼ erosion to subchondral bone.…”

Tunnel Enlargement Correlates With Postoperative Posterior Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction

“…For the femoral tunnel, we cleared the soft tissue, including the remnants of the torn PCL, using a mechanical shaver and visualized the anatomic landmarks for the PCL femoral footprint. 7 We then separately inserted two 2.4-mm k-wires into the center of the AL and posteromedial (PM) bundles of the PCL footprints using the inside-out manner at 100° to 110° of knee flexion. Subsequently, to match the diameters of the grafts, two 15- to 20-mm sockets were created by overdrilling via the k-wires, with a diameter of 6.0 to 8.0 mm for the AL tunnel and 5.0 to 6.0 mm for the PM tunnel.…”