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Histological and ultrastructural evaluation of Leeds-Keio ligament 20 years after implant: a case report

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

We were capable of undertaking a histological and ultrastructural evaluation of an intact Leeds-Keio ligament implanted 20 years ago to assess the neoligamentization process inside this artificial ligament. The histological evaluation disclosed a collagen fibrils orientation very close to the structure of a normal anterior cruciate ligament (ACL) where the collagen fibres are multidirectional [Strocchi et al. in J Anat 180(3):515–519, 1992]. On the other hand we found an unimodal distribution of collagen fibrils in the reconstructed ACL. This suggests that even at long-term follow-up stress exerts a variable influence. The multidirectional arrangement of collagen fibres resembles a normal ACL, but the unimodal distribution of fibrils is quite different from those seen in normal tendon and ligaments which tend to have a bimodal peak [Decker et al. in J Submicrosc Cytol Pathol 23:9–21, 1991; Strocchi et al. in J Anat 180(3):515–519, 1992]. Studies based on biopsy suffer from the potential weakness that the specimen may not have been representative of the entire prosthesis. Further long-term studies, possibly with the entire prosthesis and not only a biopsy, would highlight the behaviour and remodelling of this artificial ligament in greater detail and could be important for the development of future generations of artificial ligaments or tissue engineering ACL reconstruction.

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Acknowledgments

This study was developed in collaboration with: Giovanni Giordano, MD and Danilo Bruni, MD.

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Authors and Affiliations

  1. Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, via di Barbiano, 1/10, 40100, Bologna, Italy

    Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli, Vikram Chatrath, Alice Bondi & Maurilio Marcacci

  2. Dipartimento di Anatomia Umana, Università degli Studi di Bologna, via Irnerio 48, 40100, Bologna, Italy

    Viviana De Pasquale, Desiree Martini & Beatrice Bacchelli

Authors
  1. Stefano Zaffagnini
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  2. Giulio Maria Marcheggiani Muccioli
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  3. Vikram Chatrath
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  4. Alice Bondi
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  5. Viviana De Pasquale
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  6. Desiree Martini
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  7. Beatrice Bacchelli
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  8. Maurilio Marcacci
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Correspondence to Stefano Zaffagnini.

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Zaffagnini, S., Marcheggiani Muccioli, G.M., Chatrath, V. et al. Histological and ultrastructural evaluation of Leeds-Keio ligament 20 years after implant: a case report. Knee Surg Sports Traumatol Arthr 16, 1026–1029 (2008). https://doi.org/10.1007/s00167-008-0608-9

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  • DOI: https://doi.org/10.1007/s00167-008-0608-9

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