The fetal anterior cruciate ligament: an Anatomic and histologic study
The fetal anterior cruciate ligament: an Anatomic and histologic study
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DOI：
10.1016/j.arthro.2006.11.006
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发表时间：
2007-03-01
影响因子：
4.7
通讯作者：
Fu, Freddie H.
中科院分区：
文献类型：
--
作者：
Ferretti, Mario;Levicoff, Eric A.;Fu, Freddie H.
目的：本研究的目的是更好地了解前交叉韧带（ACL）的胎儿发育;确定ACL的大体解剖结构;对韧带进行完整的组织学评价，特别是关于束之间的区别;并评价ACL长度、直径、细胞结构、血管分布和插入部位。方法：采用40个完整的人胎膝关节，在体视显微镜下观察ACL的大体解剖。在矢状面（n = 20）和横断面（n = 10）上进行组织学评价。结果：大体观察显示存在两个不同的束：前内侧（AM）和后外侧（PL）。每个ACL束的股骨起点位于股骨外侧髁内侧面的后部。胫骨止点的足印为卵圆形，AM束位于PL束的前方和内侧。ACL的平均长度为3.7 mm，平均宽度为1.1 mm，平均厚度为0.9 mm。细胞密度高，约为5，600个细胞/mm（2），血管丰富。AM和PL束被一个界限清楚的隔膜分开。与胫骨止点相比，股骨起始点的结缔组织密度较低。结论：从胎儿发育开始，ACL就由AM和PL两束组成。胎儿ACL的大体形态与成人报告的相似;组织学在细胞结构和血管分布方面存在差异。临床相关性：本研究提供了有关胎儿ACL解剖学和组织学的有用信息。
Purpose: The purposes of this study were to better understand the fetal development of the anterior cruciate ligament (ACL); to identify the gross anatomy of the ACL; to perform a complete histologic evaluation of the ligament, particularly with respect to the distinction between bundles; and to evaluate ACL length, diameter, cellularity, vascularity, and insertion sites. Methods: By use of 40 intact knee joints of human fetuses, the gross anatomy of the ACL was inspected under a stereomicroscope (n = 40). The histologic evaluation was performed on the sagittal (n = 20) and transverse (n = 10) sections. Results: The gross observations revealed the presence of 2 distinct bundles: anteromedial (AM) and posterolateral (PL). The femoral origin of each ACL bundle was located in the posterior aspect of the medial surface of the lateral femoral condyle. The footprint of the tibial insertion was ovoid, with the AM bundle located anterior and medial to the PL bundle. The mean length of the ACL was 3.7 mm, the mean width was 1.1 mm, and the mean thickness was 0.9 mm. There was high cellularity, with approximately 5,600 Cells/mm(2), and intense vascularity. The AM and PL bundles were divided by a well-defined septum. The femoral origin had less dense connective tissue compared with the tibial insertion. Conclusions: From the time of fetal development, the ACL is composed of 2 bundles, AM and PL. The gross morphology of the ACL in fetuses is similar to that reported in adults; the histology is diverse in cellularity and vascularity. Clinical Relevance: This study provides useful information about the anatomy and histology of the fetal ACL.