Hira Lal Nag1, Gunjar Jain2, Vivek Vijayakumar1, Tony George Jacob3, Mukinkumar Sonai4, Sanjeev Lalwani5. 1. Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, 110049. 2. Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, 110049. drgunjarjain@gmail.com. 3. Department of Anatomy, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, 110029. 4. Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, 110029. 5. Department of FMT, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, 110029.
Abstract
PURPOSE: We have consistently observed a connective tissue lining over the intercondylar notch's roof (CTLINR) during arthroscopic surgeries of the knee joint. As there is a strong association of the intercondylar fossa with the anterior cruciate ligament (ACL), we believe that this tissue must be having some role in the functioning of the ACL. The purpose of this pilot study was to investigate the anatomic characteristics of the CTLINR. METHODS: In this observational anatomical study, we have investigated the gross anatomical and histological features of the CTLINR in four knees of two fresh frozen non-embalmed cadavers. We have also studied its ultrastructural characteristics by obtaining an arthroscopic biopsy of the tissue from a patient undergoing ACL reconstruction. RESULTS: At gross examination, the CTLINR had a typical glistening white surface with transversely oriented fibres. It entirely covered the roof of the intercondylar notch and was soft to touch. Histological examination with haematoxylin-eosin stain revealed fibro-collagenous tissue with intervening blood vessels. Transmission electron microscopy manifested loosely arranged collagen fibres of variable diameter. CONCLUSION: The histological and electron microscopic characteristics of the tissue differentiate it from the ACL and its femoral enthesis, suggesting that it was a distinct anatomical structure. As it entirely covered the roof of the intercondylar fossa and had a smooth surface and soft consistency, it may protect the reconstructed ACL from graft abrasion. Furthermore, as it had a characteristic arthroscopic appearance, future research can investigate its role in femoral tunnel positioning.
PURPOSE: We have consistently observed a connective tissue lining over the intercondylar notch's roof (CTLINR) during arthroscopic surgeries of the knee joint. As there is a strong association of the intercondylar fossa with the anterior cruciate ligament (ACL), we believe that this tissue must be having some role in the functioning of the ACL. The purpose of this pilot study was to investigate the anatomic characteristics of the CTLINR. METHODS: In this observational anatomical study, we have investigated the gross anatomical and histological features of the CTLINR in four knees of two fresh frozen non-embalmed cadavers. We have also studied its ultrastructural characteristics by obtaining an arthroscopic biopsy of the tissue from a patient undergoing ACL reconstruction. RESULTS: At gross examination, the CTLINR had a typical glistening white surface with transversely oriented fibres. It entirely covered the roof of the intercondylar notch and was soft to touch. Histological examination with haematoxylin-eosin stain revealed fibro-collagenous tissue with intervening blood vessels. Transmission electron microscopy manifested loosely arranged collagen fibres of variable diameter. CONCLUSION: The histological and electron microscopic characteristics of the tissue differentiate it from the ACL and its femoral enthesis, suggesting that it was a distinct anatomical structure. As it entirely covered the roof of the intercondylar fossa and had a smooth surface and soft consistency, it may protect the reconstructed ACL from graft abrasion. Furthermore, as it had a characteristic arthroscopic appearance, future research can investigate its role in femoral tunnel positioning.
Authors: R Strocchi; V de Pasquale; P Gubellini; A Facchini; M Marcacci; R Buda; S Zaffagnini; A Ruggeri Journal: J Anat Date: 1992-06 Impact factor: 2.610
Authors: John A Tanksley; Brian C Werner; Evan J Conte; David P Lustenberger; M Tyrrell Burrus; Stephen F Brockmeier; F Winston Gwathmey; Mark D Miller Journal: Orthop J Sports Med Date: 2017-05-18