Anterior cruciate ligament changes in the human knee joint in aging and osteoarthritis
Open Access
- 17 October 2011
- journal article
- research article
- Published by Wiley in Arthritis & Rheumatism
- Vol. 64 (3), 696-704
- https://doi.org/10.1002/art.33417
Abstract
Objective The development and patterns of spontaneous age‐related changes in the anterior cruciate ligament (ACL) and their relationship to articular cartilage degeneration are not well characterized. This study was undertaken to investigate the types and temporal sequence of age‐related ACL changes and to determine their correlation with cartilage lesion patterns at all stages of osteoarthritis (OA) development in human knee joints without prior joint trauma. Methods Human knee joints (n = 120 from 65 donors ages 23–92) were obtained at autopsy, and ACLs and cartilage were graded macroscopically and histologically. Inflammation surrounding the ACL was assessed separately. Results Histologic ACL substance scores and ligament sheath inflammation scores increased with age. Collagen fiber disorganization was the earliest and most prevalent change. The severity of mucoid degeneration and chondroid metaplasia in the ACL increased with the development of cartilage lesions. A correlation between ACL degeneration and cartilage degeneration was observed, especially in the medial compartment of the knee joint. Conclusion Our findings indicate that ACL degeneration is highly prevalent in knees with cartilage defects and may even precede cartilage changes. Hence, ACL deficiencies may not only be important in posttraumatic OA, but may also be a feature associated with knee OA pathogenesis in general.Keywords
Funding Information
- NIH (AG-007996)
- Sam and Rose Stein Endowment Fund
- Arthritis Foundation
- Postdoctoral Fellowship from the Arthritis National Research Foundation
This publication has 42 references indexed in Scilit:
- Anterior Cruciate Ligament—Injured Subjects Have Smaller Anterior Cruciate Ligaments than Matched ControlsThe American Journal of Sports Medicine, 2009
- Age‐dependent changes in matrix composition and organization at the ligament‐to‐bone insertionJournal of Orthopaedic Research, 2006
- Correlation between macroscopic changes of arthrosis and the posterior cruciate ligament histology in the osteoarthritic kneeAnz Journal of Surgery, 2005
- Cruciate ligament integrity in osteoarthritis of the kneeArthritis & Rheumatism, 2005
- Interspecies Variation in the Fibroblast Distribution of the Anterior Cruciate LigamentThe American Journal of Sports Medicine, 2004
- Retain or sacrifice the posterior cruciate ligament in total knee arthroplasty? A histopathological study of the cruciate ligament in osteoarthritic and rheumatoid diseaseJournal of Clinical Pathology, 2001
- Macroscopic and histological assessments of the cruciate ligaments in arthrosis of the kneeActa Orthopaedica, 2001
- Fibroblast distribution in the anteromedial bundle of the human anterior cruciate ligament: The presence of α‐smooth muscle actin‐positive cellsJournal of Orthopaedic Research, 1999
- Risk factors for incident radiographic knee osteoarthritis in the elderly. The framingham studyArthritis & Rheumatism, 1997
- The Influence of Mechanical Forces on the Glycosaminoglycan Content of the Rabbit Flexor Digitorum Profundus TendonConnective Tissue Research, 1979