Abstract

AimNinety percent of knee ligament injuries involve the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL) of the knee joint. Matrix metalloproteinases (MMPs) are a large group of calcium- and zinc-dependent endopeptidases responsible for cleaving and rebuilding various connective tissue components. Previous studies showed that MMP-2 and 9 have a significant effect on the healing process of injured ligaments. Therefore, the aim of this study was to evaluate for the first time in literature the expression and localization of MMP-2 and 9 in the epiligament (EL) and the ligament tissue of the MCL and the ACL of the human knee joint in order to assess their role in ligament healing.Materials and methodsFor the present study, we used histological material from the mid-portion of the MCL and the ACL of 14 knee joints from fresh cadavers. For the purpose of the immunohistochemical analysis, we used primary polyclonal antibodies against MMP-2 and 9. The obtained results were evaluated semi-quantitatively through ImageJ.ResultsImmunoreactivity for MMP-2 was predominantly positive (2+) in the EL of the MCL and remained mostly negative (0) in the ligament tissue. The expression of MMP-9 was mostly low-positive (1+) in the EL of the MCL and almost entirely negative (0) in the ligament tissue. In the EL of the ACL, the immunohistochemical expression of MMP-2 was predominantly low-positive (1+) and that of the MMP-9 was read as mostly low-positive (1+). Expression of the two enzymes in the ligament tissue was similar to the MCL.ConclusionThe present study is the first comparison of the expression of the aforementioned MMPs in the EL tissue of the MCL and the ACL in human knees, which may play a key role in physiological and pathophysiological processes such as tissue healing and repair and basement membrane degradation.

Highlights

  • The medial collateral ligament (MCL) of the knee joint is one of the most commonly injured ligaments of the knee [1,2]

  • The aim of this study was to evaluate for the first time in literature the expression and localization of Matrix metalloproteinases (MMPs)-2 and 9 in the epiligament (EL) and the ligament tissue of the MCL and the anterior cruciate ligament (ACL) of the human knee joint in order to assess their role in ligament healing

  • The aim of this study was to evaluate for the first time in literature the expression and localization of MMP-2 and 9 in the EL and the ligament tissue of the MCL and ACL in the human knee joint in order to assess their role in ligament healing

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Summary

Introduction

The medial collateral ligament (MCL) of the knee joint is one of the most commonly injured ligaments of the knee [1,2]. Ninety percent of knee ligament injuries involve the MCL or the anterior cruciate ligament (ACL) [2,3]. In 2017, Georgiev et al [4] hypothesised that the EL of the MCL has specific characteristics and suggested that the fibroblasts in particular, together with the abundant blood vessels are essential for its nutrition and healing. These data were in line with the previous studies on the MCL in rat model [9-12, 1317]. The biological basis for failure of the human ACL to heal after rupture is still unknown

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