Korean J Sports Med.  2012 Dec;30(2):130-136. 10.5763/kjsm.2012.30.2.130.

The Histologic Mapping of Sensory Innervation in the Human Anterior Cruciate Ligament

• Kim KM
• Chun CH
• Kim BG

• KMID: 2288603
• DOI: http://doi.org/10.5763/kjsm.2012.30.2.130

Abstract

Recently, rising curiosity on remnant preservation technique of anterior cruciate ligament (ACL) reconstruction, there is much interested in being and distribution of the mechanoreceptor of ACL. So, we performed histologic analyzing and mapping of sensory nerve fiber of the human ACL in this study. Total of 20 anterior cruciate ligaments were obtained from total knee replacement. Each ACL samples was divided into seven specimens; tibial insertion site, mid transitional site, femoral insertion site, and in between the sites, and total of 140 tissue samples were stained with hematoxylin-eosin and immunohistochemical, and observed with light microscope. Five hundred thirty-four fine neuroparticle structures, Ruffini corpuscles, and free nerve endings were observed in 20 ACL samples. The mean of fibers observed were 1.88, 1.71, 1.15, 1.08, 1.15, 1.55, and 1.82, respectively from tibial insertional site to femoral insertional site. With immunohistochemical stain, S-100 protein was strong positive at nerve cells, but was weak positive or negative at neurofilament. Mapping of sensory nerve distribution were done based on the results. We identified the mechanoreceptor of the human ACL using optical and immunohistochemical methods and mapped the histologic distribution of that.

Keyword

Anterior cruciate ligament; Proprioception; Histological mapping; Mechanoreceptor

MeSH Terms

Anterior Cruciate Ligament
Arthroplasty, Replacement, Knee
Exploratory Behavior
Humans
Light
Mechanoreceptors
Nerve Endings
Nerve Fibers
Neurons
Proprioception
S100 Proteins
S100 Proteins

Figure

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  Fig. 1 (A) Intraoperative photograph showed gross finding of healthy anterior cruciate ligaments. (B) The anterior cruciate ligament was completely excised with attached bone blocks and was tagged at femoral attachment site. (C) The specimens was respectively cross-sectioned by 7 groups.

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  Fig. 2 (A) Ruffini's corpuscles and bundle with perineurium are observed (H&E, ×100). (B) Nerve bundles with perineurim are seen in the loose and dense connective tissues (H&E, ×400) (black arrow).

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  Fig. 3 (A) S-100 protein positive nerve cells are presented by immunohistochemical staining for S-100 protein (×100). (B) S-100 protein positive nerve cells are presented by immunohistochemical staining for S-100 protein (×400) (black arrow).

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  Fig. 4 Typical mapping of an anterior cruciate ligament specimen representing the frequency and distribution of neural structures. TI: tibial insertion, FI: femoral insertion, S: segment.

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  Fig. 5 Site dependent difference of nerve cell numbers.

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