Abstract
BackgroundProprioception is a specialized sensory modality encompassing the movement of the joint and its position in space. Reconstruction of the anterior cruciate ligament (ACL) does not always yield expected outcome, suggesting that successful reconstruction depends on not only the ultimate strength of the graft but also recovery of proprioception. Treatment delay is a significant concern in developing countries, e.g., in Asia. Thus, presence of mechanoreceptors is one of the factors having paramount importance for successful outcome. We conducted this study to identify mechanoreceptors via immunohistochemical staining and correlate their presence with duration of injury.Materials and methodsA total of 38 injured native ACL stumps were harvested from patients undergoing ACL reconstruction and stained with neurofilament protein stain to detect functional mechanoreceptors.ResultsOf the specimens, 44.7% stained positive for monoclonal antibody. No association was found between duration of injury and presence of mechanoreceptors (p = 0.897). No correlation was seen between age and side.ConclusionsNo correlation was found between duration of injury and presence of viable mechanoreceptors, hence it is beneficial to preserve the native ACL stump irrespective of the time interval between injury and surgery.Level of EvidenceIII.
Highlights
Proprioception is a specialized sensory modality encompassing the movement of the joint and its position in space
No correlation was found between duration of injury and presence of viable mechanoreceptors, it is beneficial to preserve the native anterior cruciate ligament (ACL) stump irrespective of the time interval between injury and surgery
We evaluated the proprioceptive potential of the ACL stump in human knees with complete ACL tear using mononuclear antibodies to neurofilament protein (NFP) and correlated the results with duration of injury
Summary
Proprioception is a specialized sensory modality encompassing the movement of the joint and its position in space. Presence of mechanoreceptors in the anterior cruciate ligament (ACL) has been well documented in the past by various authors [1,2,3,4,5,6]. Barrack et al [17] found an increase in the mechanoreceptors in the ACL graft 6 months after surgery as compared with the normal patellar tendon in canines. Denti et al [14] found mechanoreceptors in bone patellar tendon autograft in sheep knees 3 months after implantation, and in two lax human knees with failed semitendinosus autografts 9 and 10 years after surgery, leading to the conclusion that the ACL remnant is a possible source of neural reinnervation of the graft. We conducted this study to identify mechanoreceptors via immunohistochemical staining and correlate their presence with duration of injury
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