Histopathological and macroscopic evaluation of the ACL and its correlation to other variables in patients undergoing primary total knee arthroplasty: A prospective study of 50 cases

Abstract

More and more interest is evoked now a days regarding preservation of cruciate ligaments in total knee arthroplasty. This requires strong scientific evidence before undertaking such procedure. This study assessed gross and histopathological ACL changes in arthritic knees (n=50) undergoing total knee arthroplasty. Method: Histopathological changes were assessed and graded as absent (0), mild (1), moderate (2), or marked (3). These were correlated to demographic and clinical factors and radiographic evaluations. Result: The ACL was intact in 6, frayed in17, torn in 3 and linear striated in 24 knees. Hundred (100%) percent had histological changes. Overall, there were significant associations between greater age, higher BMI, female sex and histological changes. Increased age had significantly greater acellular zones and number of pathologic changes. Conclusion: These correlations may aid decision-making when determining suitability for unicompartmental or bicruciate-retaining arthroplasties, though further studies should correlate these histological findings to mechanical and functional knee status.