Purpose
To describe the morphology and distribution of the anterolateral ligament of the knee
(ALL) nerve endings, aiming to understand the interaction between the proprioceptive
system and knee mechanics.
Methods
Twenty ALLs were obtained from fresh frozen cadavers. The ligaments were measured,
weighed, and cut. Sections (10 μm) were prepared in hematoxylin and eosin–stained
slides to analyze tissue integrity, and 50-μm sections were subjected to immunofluorescence
with the protein gene product 9.5 as primary antibody and Alexa Fluor 488 as secondary
antibody, followed by microscopic analysis.
Results
The ALL was identified in 100% of the dissections, exhibiting a mean (± standard deviation)
length of 4.0 ± 0.4 cm, a mean width of 5.5 ± 0.8 mm, and a mean weight of 0.9 ± 0.2 g.
The histological sections in hematoxylin and eosin showed dense, well-organized collagen
and the presence of vascular tissue. All the specimens analyzed contained type I (Ruffini-like)
mechanoreceptors and free nerve endings (type IV), varying from parallel to intertwined
fibers. Unclassified nerve endings with different irregular shapes were also found.
The neural elements occupied 0.6% ± 0.3% of the ligament area, and most were observed
near the origin of ALL insertions.
Conclusion
The ALL exhibits a peripheral nerve structure, primarily type I and IV mechanoreceptors.
These findings suggest that the ALL is important for the proprioception and anterolateral
stabilization of the knee.
Clinical Relevance
It is important to understand ALL innervation and infer how an injury could compromise
the proprioceptive role of the lateral compartment, as the ligaments contribute dynamically
to stability through proprioceptive control of muscle forces. The findings confirm
that the ALL is highly innervated by mechanoreceptors and may have a proprioceptive
role in conjunction with the lateral collateral ligament in the lateral region of
the knee.
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Article info
Publication history
Accepted:
May 10,
2019
Received:
December 13,
2018
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
See commentary on page 2929
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Knee Anterolateral Ligament Mechanoreceptors: The First Step From Peripheral to Central Nervous SystemArthroscopyVol. 35Issue 10
- PreviewThe mechanoreceptors around the knee are of interest, including those mechanoreceptors related to the anterolateral ligament. Histopathologic evaluations of mechanoreceptors are the first steps in understanding the exact sensorimotor system of the extremities. Many studies have shown these mechanoreceptors, but more electrophysiologic studies are needed to make sense of the reported phenomena.
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