Skip to main content
SpringerLink
Log in

A study of the synovial and ligamentous structure of the anterior cruciate ligament

  • Published:
International Orthopaedics Aims and scope Submit manuscript

Summary

The synovial and ligamentous structure of 16 human anterior cruciate ligaments (ACL), removed at autopsy, were examined by light microscopy with special regard to their topographical relationships. The soft tissue support of the ACL consists of fibrous, areolar and areolo-adipose synovial tissue. The subsynovial layer comprises a tight fibrous peripheral part and an element of loose connective tissue containing some tight connective tissue strands, vessels and nerves. The collagenous ligamentous part of the ACL is the proper functional tissue and contains approximately 1500 fascicles measuring an average of 250 μm in diameter. These fascicles are composed of bundles of collagen fibres, fibrocytes and deposits of proteoglycans. The synovial and ligamentous structures are attached by the second part of the subsynovial layer, which radiates into the ligamentous tissue and envelops the fascicles like a sheath. By this means the biological connection between these two structures is guaranteed.

The relevance of these findings to operative reconstruction of recent ligamentous injuries is discussed.

Résumé

Etude microscopique de 16 ligaments croisés antérieurs (L. C. A.) prélevés post-mortem en conservant la continuité topographique de leur structure synoviale et ligamentaire. Le revêtement synovial du L. C. A. se compose de trois types différents de tissu: fibreux, aréolaire et aréolo-adipeux. La synoviale elle-même est constituée de deux couches dont la seconde partie, la sous-synoviale, se différencie en une partie périphérique, fibreuse et dense et une partie faite de tissu conjonctif lâche, porteur des structures vasculaires et nerveuses. Le tissu collagène du L. C. A., le vrai tissu fonctionnel, contient environ 1500 fascicules d'un diamètre moyen de 250 μm. Ces fascicules sont constitués de faisceaux de fibres collagènes, de fibrocytes et de protéoglycans. Les structures synoviales et ligamentaires sont reliées entre elles par l'intermédiaire de la couche sous-synoviale qui irradie dans le tissu ligamentaire dont elle engaîne les fascicules. Ainsi est établie une connexion biologique entre ces deux structures.

Les conséquences de cette étude sur la réparation chirurgicale des ruptures récentes du L. C. A. sont discutées.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abbott LRC, Saunders JBDM, Bost FC, Anderson CE (1944) Injuries to the ligaments of the knee joint. J Bone Joint Surg 26: 503–521

    Google Scholar 

  2. Alm A, Strömberg B (1974) Vascular anatomy of the patellar and cruciate ligaments. Acta Chir Scand (Suppl) 445: 25–35

    Google Scholar 

  3. Amiel D, Frank C, Harwood F, Fronek J, Akeson W (1984) Tendons and ligaments: A morphological and biochemical comparison. J Orthop Res 1: 257–265

    Google Scholar 

  4. Arnoczky SP, Rubin RM, Marshall JL (1979) Microvasculature of the cruciate ligaments and its response to injury. J Bone Joint Surg (Am) 61: 1221–1229

    Google Scholar 

  5. Arnoczky SP (1983) Anatomy of the anterior cruciate ligament. Clin Orthop 172: 19–25

    Google Scholar 

  6. Barland P, Novikoff AB, Hamerman D (1962) Electron microscopy of the human synovial membrane. J Cell Biol 14: 207–220

    Google Scholar 

  7. Beauchamp P, Laurin CA (1976) Le ligament croisé antérieur: Notions actuelles. Union Med Can 105: 1380–1386

    Google Scholar 

  8. Bloom W, Fawcett DW (1975) A textbook of histology, Saunders Company, Philadelphia London Toronto, pp 158–195

    Google Scholar 

  9. Brantigan OC, Voshell AF (1941) The mechanics of the ligaments and menisci of the knee joint. J Bone Joint Surg 23: 44–66

    Google Scholar 

  10. Castor CW (1960) The microscopic structure of normal human synovial tissue. Arthritis Rheum 3: 140–151

    Google Scholar 

  11. Clancy WG, Narechania RG, Rosenberg TD, Gmeiner JG, Wisnefske DD, Lange TA (1981) Anterior and posterior cruciate ligament reconstruction in rhesus monkeys. J Bone Joint Surg (Am) 63: 1270–1284

    Google Scholar 

  12. Danylchuk KD, Finlay JB, Krcek JP (1978) Microstructural organization of human and bovine cruciate ligaments. Clin Orthop 131: 294–298

    Google Scholar 

  13. Davies DV, Barnett CH (1960) Struktur und Funktion der Synovialgewebe. In: Baur KF (ed) Medizinische Grundlagenforschung, Band III. Thieme, Stuttgart pp 625–650

    Google Scholar 

  14. Dejour H (1983) Analyse critique des résultats du traitement des laxités fraîches. Déduction thérapeutique, Conclusion-Indication dans les laxités fraîches. Rev Chir Orthop 69: 269–270

    Google Scholar 

  15. Elmore SM, Malmgren RA, Sokoloff L (1963) Sclerosis of synovial blood vessels. J Bone Joint Surg (Am) 45: 318–326

    Google Scholar 

  16. Erlanger J, Gasser HS (1937) Electrical signs of nervous activity. Univ. Pennsylvania Press, Philadelphia

    Google Scholar 

  17. Feagin JA, Curl WW (1976) Isolated tear of the anterior cruciate ligament: 5-year follow-up study. Am J Sports Med 4: 95–100

    Google Scholar 

  18. Fick R (1904) Handbuch der Anatomie und Mechanik der Gelenke unter Berücksichtigung der bewegenden Muskeln. Gustav Fischer, Jena, pp 341–394

    Google Scholar 

  19. Gamble JG, Edwards CC, Max SR (1984) Enzymatic adaptation in ligaments during immobilization. Am J Sports Med 12: 221–228

    Google Scholar 

  20. Gerrits PO, Smid L (1983) A new, less toxic polymerization system for the embedding of soft tissues in glycol methacrylate and subsequent preparing of serial sections. J Microsc 132: 81–85

    Google Scholar 

  21. Ghadially FN (1983) Fine structure of synovial joints. Butterworths, London Boston Durban Singapore Sidney Toronto Wellington

    Google Scholar 

  22. Girgis FG, Marshall JL, Al Monajem ARS (1975) The cruciate ligaments of the knee joint. Clin Orthop 106: 216–231

    Google Scholar 

  23. Huth F, Klein W, Douros TH, Jacobs G (1976) Experimentelle lymphostatische arthropathie. Beitr Orthop Traumatol 23: 689–695

    Google Scholar 

  24. Huth F (1983) General pathology of the lymphovascular system. Special pathology of the lymphovascular system. In: Földi M, Casley-Smith JR (eds) Lymphangiology. Schattauer, Stuttgart New York, pp 215–334; 377–474

    Google Scholar 

  25. Karnovsky J (1965) A formaldehyde-glutaraldehyde fixative of high osmolality for use in electron microscopy. J Cell Biol 27: 137A-138A

    Google Scholar 

  26. Kennedy JC, Weinberg HW, Wilson AS (1974) The anatomy and function of the anterior cruciate ligament. J Bone Joint Surg (Am) 56: 223–235

    Google Scholar 

  27. Key JA (1928) The synovial membrane of joints and bursae. In: Cowdry EV (ed) Special cytology. Hoeber, New York, pp 737–765

    Google Scholar 

  28. Lang J (1958) Die Gelenkinnenhaut, ihre Aufbau- und Abbauvorgänge. Gegenbauers Morphol Jahrb 98: 387–482

    Google Scholar 

  29. Langer E, Huth F (1960) Untersuchungen über den submikroskopischen Bau der Synovialmembran. Z Zellforsch 51: 545–559

    Google Scholar 

  30. Lever JD, Ford EHR (1958) Histological, histochemical and electron microscopic observations on synovial membrane. Anat Rec 132: 525–539

    Google Scholar 

  31. Levick JR (1980) Contributions of the lymphatic and microvascular systems to fluid absorption from the synovial cavity of the rabbit knee. J Physiol London 306: 445–461

    Google Scholar 

  32. Marquort W (1931) Zur Histologie der Synovialmembran. Z Zellforsch 12: 34–52

    Google Scholar 

  33. Marshall JL, Arnoczky SP, Rubin RM, Wickiewicz TL (1979) Microvasculature of the cruciate ligaments. Physician Sports Med 7: 87–91

    Google Scholar 

  34. Marshall JL, Warren RF, Wickiewicz TL (1982) Primary surgical treatment of anterior cruciate ligament lesions. Am J Sports Med 10: 103–107

    Google Scholar 

  35. O'Donoghue DH, Rockwood CA, Zaricznyj B, Kenyon R (1961) Repair of knee ligaments in dogs. J Bone Joint Surg (Am) 43: 1167–1178

    Google Scholar 

  36. O'Donoghue DH (1963) A method for replacement of the anterior cruciate ligament of the knee. J Bone Joint Surg (Am) 45: 905–924

    Google Scholar 

  37. Odensten M, Gillquist J (1985) Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg (Am) 67: 257–262

    Google Scholar 

  38. Pfab B (1927) Zur Blutgefäßversorgung der Menisci und Kreuzbänder Dtsch Z Chir 205: 258–264

    Google Scholar 

  39. Pförringer W (1982) Hämarthros und Kreuzbänder — biomechanische Untersuchungen. Unfallchirurg 8: 353–367

    Google Scholar 

  40. Rosenberg M, Bartl P, Leško J (1960) Water-soluble methacrylate as an embedding medium for the preparation of ultrathin sections. J Ultrastruct Res 4: 298–303

    Google Scholar 

  41. Rubin RM, Marshall JL (1976) Vascular anatomy of the cruciate ligaments in dogs — normal and injured states. 22nd Annual ORS New Orleans, p 140

  42. Scapinelli R (1968) Studies on the vasculature of the human knee joint. Acta Anat 70: 305–331

    Google Scholar 

  43. Schultz RA, Miller DC, Kerr CS, Micheli L (1984) Mechanoreceptors in human cruciate ligaments. J Bone Joint Surg (Am) 66: 1072–1076

    Google Scholar 

  44. Vladmirov B (1968) Arterial sources of blood supply of the knee joint in man. Acta Med Inst Superior Med 47: 1–10

    Google Scholar 

  45. Weaver JK, Derkash RS, Freeman JR, Kirk RE, Oden RR, Matyas J (1985) Primary knee ligament repair — revisited. Clin Orthop 199: 185–191

    Google Scholar 

  46. Whiteside LA, Sweeney RE (1980) Nutritient pathways of the cruciate ligaments. J Bone Joint Surg (Am) 62: 1176–1180

    Google Scholar 

  47. Zimny ML, Schutte M, Dabezies E (1986) Mechanoreceptors in the human anterior cruciate ligament. Anat Rec 214: 204–209

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Staatlich Orthopädische Klinik München, Harlachinger Straße 51, D-8000, München 90, Federal Republic of Germany

    J. Haus & H. J. Refior

Authors
  1. J. Haus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. J. Refior
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haus, J., Refior, H.J. A study of the synovial and ligamentous structure of the anterior cruciate ligament. International Orthopaedics 11, 117–124 (1987). https://doi.org/10.1007/BF00266696

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00266696

Key words

Search

Navigation