Degeneration of the Cruciate Ligaments in Osteoarthritic Knee

ABSTRACT

PURPOSE: To assess the histological degeneration of the cruciate ligaments and it's correlation with gross appearance of the cruciate ligaments and functional status of the knee. MATERIALS AND METHODS: Macroscopic and microscopic evaluations of cruciate ligaments were made in 80 osteoarthritic knees undergoing cruciate-substituting total knee arthroplasty (TKA). Gross appearance was classified into "normal", "abnormal" and "tear". A scoring system was made to represent the degree of histological degeneration, and correlation with the gross appearance and functional status by knee society score (KSS) was statistically analysed. RESULT: Gross appearance of the anterior cruciate ligament (ACL) was "normal" in 24 cases, "abnormal" in 50 and "tear" in 6 with average histological score 3.7, 4.5 and 8.0 respectively. Gross appearance of the posterior cruciate ligament (PCL) was "normal" in 70, "abnormal" in 10 with average histological score 3.8 and 6.4 respectively. There was no "tear" of the PCL. Gross appearance of the ACL was correlated with histological score of ACL and PCL (p<0.05) and KSS (p<0.05). CONCLUSION: Gross appearance of the ACL was related to the degree of histological degeneration of the PCL as well as the ACL and functional loss of the knee. Therefore intraoperative gross appearance of the ACL can be one of the factors to decide if the PCL would be sacrificed or not during TKA.