Biological aspects of long-term failure of autografts after cruciate ligament replacement

Abstract
The alterations of the ultrastructure of the posterior cruciate ligament autograft of patellar tendon origin were examined in a sheep model 1 year after surgery. The ultrastructure was also compared with that of the normal contralateral posterior cruciate ligament and patellar tendon. The most striking finding was the unimodal distribution of the collagen fibrils, with a predominance of loosely packed thin fibrils in the central portion of the autograft. The results suggested that the remodeled autograft tissue became highly organized but never exhibited the ultrastructural features of a ligament. This could be responsible for the decreased biomechanical properties and the long-term failure of a patellar tendon autograft. Die ultrastrukturellen Veränderungen eines freien Patellarsehnentransplantates beim hinteren Kreuzbandersatz wurden in einem Schafsmodell 1 Jahr nach Transplantation untersucht. Die Feinstruktur der normalen kontralateralen Patellarsehne und des hinteren Kreuzbandes wurden mit der des Transplantates verglichen. Die unimodale Verteilung der Fibrillendurchmesser zugunsten dünner Fibrillen im zentralen Bereich des Transplantates werden als Ursache für die verminderten biomechanischen Eigenschaften und die langfristige Transplantatinsuffizienz diskutiert.

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