Histopathological Evaluation of the Anterior Cruciate Ligament in Patients Undergoing Primary Total Knee Arthroplasty

J Arthroplasty. 2016 Jan;31(1):284-9. doi: 10.1016/j.arth.2015.07.010. Epub 2015 Jul 11.

Abstract

This study assessed gross and histopathological ACL changes in arthritic knees (n=174) undergoing total knee arthroplasty. Histopathological changes were assessed and graded as absent (0), mild (1), moderate (2), or marked (3). These were correlated to demographic and clinical factors, and radiographic evaluations. The ACL was intact in 43, frayed in 85, torn in 15, and absent in 31 knees. Eighty-five percent had histological changes. Overall, there were significant associations between greater age and BMI, and histological changes. Grade IV knees had significantly greater calcium pyrophosphate deposits, microcyst formation, and number of pathologic changes. These correlations may aid decision-making when determining suitability for unicompartmental or bicruciate-retaining arthroplasties, though further studies should correlate these histological findings to mechanical and functional knee status.

Keywords: ACL; TKA; anterior cruciate ligament; bicruciate-retaining arthroplasty; cruciate retaining; histology.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Cruciate Ligament / pathology*
  • Anterior Cruciate Ligament / surgery*
  • Arthroplasty, Replacement, Knee*
  • Body Mass Index
  • Calcium Pyrophosphate / chemistry
  • Decision Making
  • Female
  • Humans
  • Inflammation
  • Knee Joint / pathology
  • Knee Joint / surgery*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / pathology
  • Prospective Studies

Substances

  • Calcium Pyrophosphate