Abstract
Purpose: Ultrastructural analysis of PT graft for ACL single bundle reconstruction.
Materials and methods: Arthroscopical biopsies for new meniscal lesions at 6-12-24mm-5-10 ys. All cases with IKDC normal/nearly normal and KT2000 excellent/good.
Samples prepared with Karnowsky fixing and urani-lacetate solution. Fibril diameter and transversal area measured by LEICA QUIN in 5 cuts randomly selected for each sample.
Results: 6 months biopsy showed severe P.T. modifications, with a decrease of larger fibrils, substituted with smaller one with plenty of extra cellular matrix. Oxitalan fibers, macrophagic cells and tenocytes were observed. At 12 months compact fascicles of small fibrils (50–60 nm) divided the larger one, similar to a normal tendon. At 24 months graft modifications were increased with wide compact fasciclesvariously oriented. At 5 and 10 years the modifications were similar to those observed at 2 years, with the graft not completely transformed in native ACL structure.
Discussion: The results showed that PT graft used for ACL single bundle reconstruction certainly undergoes a neoligamentization process up to two years. At longer follow-up the foresaw complete remodelling in a normal ACL was not observed. Heterogeneous fibrils presence suggests incomplete ligamentization or its impossible complete realization in single bundle ACL reconstructions.
Correspondence should be addressed to Ariella Neustadt at Studio EGA, Professional Congress Organisers, Viale Tiziano, 19 - 00196, Rome - Italy.
