Abstract：
BACKGROUND: Mucoid degeneration of the anterior cruciate ligament is a pathological condition that may impair knee mechanics and contribute to the symptomatology of osteoarthritis. This study aimed to evaluate whether preoperative magnetic resonance imaging can predict anterior cruciate ligament degeneration, specifically mucoid degeneration, and to elucidate the histopathological characteristics of mucoid degeneration in knee osteoarthritis patients.
METHODS: We evaluated a total of 95 knees of osteoarthritis patients (23 males, 72 females; mean age: 72.7 ± 7.5) scheduled for total knee arthroplasty. The relationship between preoperative magnetic resonance imaging findings and the histopathological evidence of anterior cruciate ligament mucoid degeneration was examined. Immunohistochemical analysis was employed for collagen types (COL-I, COL-II), chondrogenesis (SOX9), and vascularity (CD31).
RESULTS: High signal intensity on magnetic resonance imaging showed a positive correlation with Alcian Blue staining areas (rs = 0.59, p < 0.01) and the swelling index (rs = 0.62, p < 0.01), indicating advanced mucoid degeneration. The absence of synovial lining around the anterior cruciate ligament was associated with more severe degeneration. In the histological evaluations, advanced degeneration was characterized by an increase in chondroid metaplasia and collagen disorientation. The Alcian Blue and SOX9 correlation was positive (rs = 0.69, p < 0.01), but negative with COL-I (rs = -0.38, p = 0.03) and vascularity (CD31) (rs = -0.60, p < 0.01).
CONCLUSIONS: Preoperative magnetic resonance imaging is an effective tool in assessing the severity of anterior cruciate ligament degeneration; it influences surgical decisions. High signal intensity on magnetic resonance images denotes advanced mucoid degeneration. The absence of synovial lining around the anterior cruciate ligament is associated with more severe degeneration and may accelerate degenerative changes. Chondroid metaplasia and collagen disorientation mark advanced degeneration. Magnetic resonance imaging can be used to gauge the degree of anterior cruciate ligament degeneration in osteoarthritis.
METHODS: We evaluated a total of 95 knees of osteoarthritis patients (23 males, 72 females; mean age: 72.7 ± 7.5) scheduled for total knee arthroplasty. The relationship between preoperative magnetic resonance imaging findings and the histopathological evidence of anterior cruciate ligament mucoid degeneration was examined. Immunohistochemical analysis was employed for collagen types (COL-I, COL-II), chondrogenesis (SOX9), and vascularity (CD31).
RESULTS: High signal intensity on magnetic resonance imaging showed a positive correlation with Alcian Blue staining areas (rs = 0.59, p < 0.01) and the swelling index (rs = 0.62, p < 0.01), indicating advanced mucoid degeneration. The absence of synovial lining around the anterior cruciate ligament was associated with more severe degeneration. In the histological evaluations, advanced degeneration was characterized by an increase in chondroid metaplasia and collagen disorientation. The Alcian Blue and SOX9 correlation was positive (rs = 0.69, p < 0.01), but negative with COL-I (rs = -0.38, p = 0.03) and vascularity (CD31) (rs = -0.60, p < 0.01).
CONCLUSIONS: Preoperative magnetic resonance imaging is an effective tool in assessing the severity of anterior cruciate ligament degeneration; it influences surgical decisions. High signal intensity on magnetic resonance images denotes advanced mucoid degeneration. The absence of synovial lining around the anterior cruciate ligament is associated with more severe degeneration and may accelerate degenerative changes. Chondroid metaplasia and collagen disorientation mark advanced degeneration. Magnetic resonance imaging can be used to gauge the degree of anterior cruciate ligament degeneration in osteoarthritis.
摘要：
背景：前交叉韧带的粘液样变性是一种可能损害膝关节力学并导致骨关节炎症状的病理状况。这项研究旨在评估术前磁共振成像是否可以预测前交叉韧带退变。特别是粘液变性，并阐明膝骨关节炎患者粘液样变性的组织病理学特征。
方法：我们评估了95例骨关节炎患者的膝盖（23例男性，72名女性；平均年龄：72.7±7.5）计划进行全膝关节置换术。检查了术前磁共振成像发现与前交叉韧带粘液样变性的组织病理学证据之间的关系。免疫组织化学分析用于胶原蛋白类型(COL-I，COL-II),软骨形成（SOX9），和血管（CD31）。
结果：磁共振成像的高信号强度与AlcianBlue染色区域（rs=0.59，p<0.01）和肿胀指数（rs=0.62，p<0.01）呈正相关，表明晚期粘液变性.前交叉韧带周围滑膜衬里的缺失与更严重的变性有关。在组织学评估中，晚期变性的特征是软骨样化生和胶原蛋白定向障碍的增加。AlcianBlue与SOX9呈正相关(rs=0.69,p<0.01),但COL-I（rs=-0.38，p=0.03）和血管分布（CD31）（rs=-0.60，p<0.01）阴性。
结论：术前磁共振成像是评估前交叉韧带变性严重程度的有效工具；它影响手术决策。磁共振图像上的高信号强度表示晚期粘液样变性。前交叉韧带周围滑膜衬里的缺失与更严重的退变有关，并可能加速退变。软骨化生和胶原定向障碍标志着晚期变性。磁共振成像可用于测量骨关节炎中前交叉韧带变性的程度。
方法：我们评估了95例骨关节炎患者的膝盖（23例男性，72名女性；平均年龄：72.7±7.5）计划进行全膝关节置换术。检查了术前磁共振成像发现与前交叉韧带粘液样变性的组织病理学证据之间的关系。免疫组织化学分析用于胶原蛋白类型(COL-I，COL-II),软骨形成（SOX9），和血管（CD31）。
结果：磁共振成像的高信号强度与AlcianBlue染色区域（rs=0.59，p<0.01）和肿胀指数（rs=0.62，p<0.01）呈正相关，表明晚期粘液变性.前交叉韧带周围滑膜衬里的缺失与更严重的变性有关。在组织学评估中，晚期变性的特征是软骨样化生和胶原蛋白定向障碍的增加。AlcianBlue与SOX9呈正相关(rs=0.69,p<0.01),但COL-I（rs=-0.38，p=0.03）和血管分布（CD31）（rs=-0.60，p<0.01）阴性。
结论：术前磁共振成像是评估前交叉韧带变性严重程度的有效工具；它影响手术决策。磁共振图像上的高信号强度表示晚期粘液样变性。前交叉韧带周围滑膜衬里的缺失与更严重的退变有关，并可能加速退变。软骨化生和胶原定向障碍标志着晚期变性。磁共振成像可用于测量骨关节炎中前交叉韧带变性的程度。
