Skip to main content
SpringerLink
Log in

Nerve supply of anterior cruciate ligaments and of cryopreserved anterior cruciate ligament allografts: a new method for the differentiation of the nervous tissues

  • Originals Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

We investigated the nerve supply of anterior cruciate ligaments ((ACLs) and of cryopreserved bone-ACL-bone allografts in a rabbit model with immunohistochemical methods to establish the distribution pattern of the nervous tissues and to determine the reinnervation rate of ACL allografts. The ACL is innervated by three different classes of nerve fibre: (1) fibres of large diameter, characterized by neurofilament immunoreactivity, which are fast-conducting mechanoreceptive sensory afferents; (2) fibres of small diameter, characterized by substance Pimmunoreactivity, which are slow-conducting nociceptive sensory afferents; and (3) sympathetic efferent vasomotor fibres, characterized by their immunoreactivity to the ratelimiting enzyme of noradrenaline synthesis, tyrosine hydroxylase. The ACLs showed numerous fibres of all three nerve classes; as specialised sensory nerve endings only Ruffini corpuscles were observed. All nerve fibres were located subsynovially, none within the collagen core of the ligament itself. No nerve fibres were detected in the ACL allografts at 3 and 6 weeks. Sparse fibres were detected at 12 weeks, while the 24-, 36-and 52-week specimens showed plenty of all three fibre types. No mechanoreceptors were found in the ACL allografts. To our knowledge, this method for the first time allows a differentiation of the nerve fibres of ACLs and ACL allografts into three different nerve fibre classes with known neurophysiological functions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abbott LC, Saunders JB, Bost FC, Anderson CE (1944) Injuries to the ligaments of the knee joint. J Bone Joint Surg 26: 503–521

    Google Scholar 

  2. Arnoczky SP, Warren RF, Ashlock MA (1986) Replacement of the anterior cruciate ligament using a patellar tendon allograft. J Bone Joint Surg [Am] 68:376–385

    Google Scholar 

  3. Barad S, Cabaud HE, Rodrigo JJ (1982) The effect of storage at-80°C as compared to 4°C on the strength oof rhesus monkey anterior cruciate ligament. Trans Orthop Res Soc 7:378

    Google Scholar 

  4. Boyd IA (1954) The histological structure of the receptors in the knee joint of the cat correlated with their physiological response. J Physiol 124:476–488

    Google Scholar 

  5. Cerulli G, Ceccarini A, Alberti PF, Caraffa A, Caraffa G (1988) Mechanoreceptors of some anatomical structures of the human knee. In: Müller W, Hackenbruch W (eds) Surgery and arthroscopy of the knee. Springer, Berlin Heidelberg New York, pp 50–54

    Google Scholar 

  6. Cobbold AF, Lewis OJ (1956) The nervous control of joint blood vessels. J Physiol (Lond) 133:467–471

    Google Scholar 

  7. Coderre TJ, Basbaum AI, Levine JD (1989) Neural control of vascular permeability: interactions between primary afferents, mast cells and sympathetic efferents. J Neurophysiol 62:48–58

    Google Scholar 

  8. Craig AD, Heppelmann B, Schaible HG (1988) The projection of the medial and posterior articular nerves of the cat's knee to the spinal cord. J Comp Neurol 276:279–288

    Google Scholar 

  9. Dorn T, Schaible HG, Schmidt RF (1991) Response properties of thick myelinated group II afferents in the medial articular nerve of normal and inflamed knee joints of the cat. Somatosens Mot Res 8:127–136

    Google Scholar 

  10. Freeman MAR, Wyke B (1967) The innervation of the knee joint: an anatomical and histological study in the cat. J Anat 101:505–532

    Google Scholar 

  11. Friedlaender GE, Strong DM, Sell KW (1976) Studies on the antigenicity of bone. I. Freeze-dried and deep-frozen bone allografts in rabbits. J Bone Joint Surg [Am] 58:854–858

    Google Scholar 

  12. Fromm B, Parsch D, Kummer W (1994) Sensory innervation of the anterior cruciate ligament. Segmental distribution, size, and neurochemistry of primary afferent neurons in the rabbit. (in press)

  13. Gardner ED (1944) The distribution and termination of the nerves in the knee joint of the cat. J Comp Neurol 80:11–32

    Google Scholar 

  14. Goertzen M, Gruber J, Dellmann A, Clahsen H, Schulitz KP (1992) Neurohistological findings after experimental anterior cruciate ligament allograft transplantation. Arch Orthop Trauma Surg 111:126–129

    Google Scholar 

  15. Grigg P, Hoffman AH (1982) Ruffini mechanoreceptors in isolated joint capsule: response correlated with strain energy density. Somatosens Res 2:149–162

    Google Scholar 

  16. Grüber J, Wolter D, Lierse w (1986) Der vordere Kreuzbandreflex (LCA-Reflex). Unfallchirurg 89:551–554

    Google Scholar 

  17. Halata Z, Haus J (1989) The ultrastructure of sensory nerve endings in human anterior cruciate ligament. Anat Embryol 179:415–421

    Google Scholar 

  18. Hanesch U, Heppelmann B, Schmidt RF (1991) Substance Pand calcitonin gene-related peptide immunoreactivity in primary afferent neurons of the cat's knee joint. Neuroscience 45:185–193

    Google Scholar 

  19. Haus J, Halata Z (1990) Innervation of the anterior cruciate ligament. Int Orthop 14:293–296

    Google Scholar 

  20. Heppelmann B, Schaible HG (1990) Origin of sympathetic innervation of the knee joint in the cat: a retrograde tracing study with horseradish peroxidase. Neurosci Lett 108:71–75

    Google Scholar 

  21. Jackson DW, Good ES, Goldstein JD, Rosen MA, Kurzweil PR, Cummings JF, Simon TM (1993) A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction of the goat model. Am J Sports Med 21: 176–185

    Google Scholar 

  22. Johnson RJ (1982) The anterior cruciate: a dilemma in sports medicine. Int J Sports Med 3:71–79

    Google Scholar 

  23. Kennedy JC, Weinberg HW, Wilson AS (1974) The anatomy and function of the anterior cruciate ligament. J Bone Joint Surg [Am] 56:223–235

    Google Scholar 

  24. Klein L, Lewis JA (1972) Simultaneous quantification of3H-collagen loss and1H-collagen replacement during healing of rat tendon grafts. J Bone Joint Surg [Am] 54:137–146

    Google Scholar 

  25. Krauspe R, Schmidt M, Schaible HG (1992) Sensory innervation of the anterior cruciate ligament. J Bone Joint Surg [Am] 74:390–397

    Google Scholar 

  26. Kummer W, Habeck JO (1992) Chemoreceptor A-fibres in the human carotid body contain tyrosine hydroxylase-and neurofilament-immunoreactivity. Neuroscience 713–725

  27. Lam FY, Ferrell WR (1993) Acute inflammation in the rat knee joint attenuates sympathetic vasoconstriction but enhances neuropeptide-mediated vasodilatation assessed by laser doppler perfusion imaging. Neuroscience 52:443–449

    Google Scholar 

  28. Levine JD, Dardick SJ, Roizen MF, Helms C, Basbaum AI (1986) Contribution of sensory afferents and sympathetic efferents to joint injury in experimental arthritis. J Neurosci 6: 3423–3429

    Google Scholar 

  29. Lotz M, Carson DA, Vaughan JH (1987) Substance P activation of rheumatoid synoviocytes: neural pathway in pathogenesis of arthritis. Science 235:893–895

    Google Scholar 

  30. McCloskey DI (1978) Kinesthetic sensibility. Physiol Rev 58: 763–820

    Google Scholar 

  31. Nikolaou PK, Seaber AV, Glisson RR, Ribbeck BM, Bassett III FH (1986) Anterior cruciate ligament allograft transplantation. Am J Sports Med 14:348–360

    Google Scholar 

  32. Noyes FR, Barber S, Mangine RE (1990) Bone-patellar ligament-bone and fascia lata allografts for reconstruction of the anterior cruciate ligament. J Bone Joint Surg [Am] 72:1125–1136

    Google Scholar 

  33. Rovere GD, Adair DM (1983) Anterior cruciate-deficient knees: a review of the literature. Am J Sports Med 11:412–419

    Google Scholar 

  34. Sato O, Maeda T, Iwanaga T, Kobayashi S (1989) Innervation of the incisors and periodontal ligament in several rodents: an immunohistochemical study of neurofilament protein and gliaspecific S-100 protein. Acta Anat 134:94–99

    Google Scholar 

  35. Sato Y, Schaible HG (1987) Discharge characteristics of sympathetic efferents to the knee joint of the cat. J Auton Nerv Syst 19:95–1076

    Google Scholar 

  36. Schultz RA, Miller DC, Kerr C, Nicheli L (1984) Mechanoreceptors in human cruciate ligaments. J Bone Joint Surg [Am] 66:1972–1076

    Google Scholar 

  37. Schutte MJ, Dabezies E, Zimny ML, Happel LT (1987) Mechanoreceptors in the human anterior cruciate ligament J Bone Joint Surg [Am] 69-A:243–247

    Google Scholar 

  38. Shino K, Kawasaki T, Hirose H, Gotch I, Inoue M, Ono K (1984) Replacement of the anterior cruciate ligament by an allogeneic tendon graft. J Bone Joint Surg [Br] 66:672–681

    Google Scholar 

  39. Shino K, Kimura T, Hirose H, Gotch I, Inoue M, Ono K (1986) Reconstruction of the anterior cruciate ligament by allogeneic tendon graft. J Bone Joint Surg [Br] 68:739–746

    Google Scholar 

  40. Sjölander P, Johansson H, Sojka P, Rehnholm A (1989) Sensory nerve endings in the cat cruciate ligaments: a morphological investigation. Neurosci Lett 102:33–38

    Google Scholar 

  41. Solomonow M, Baratta R, Zhou BH, Shoji H, Bose W, Beck C, D'Ambrosia R (1987) The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability. Am J Sports Med 15:207–213

    Google Scholar 

  42. Vasseur PB, Rodrigo JJ, Stevenson S, Clark G (1987) Replacement of the anterior cruciate ligament with a bone-ligament-bone anterior cruciate ligament allograft in dogs. Clin Orthop 219:268–277

    Google Scholar 

  43. Widenfalk B, Wiberg M (1990) Origin of sympathetic and sensory innervation of the temporomandibular joint. A retrograde axonal tracing study in the rat. Neurosci Lett 109:30–35

    Google Scholar 

  44. Yaksh TL (1988) Substance P release from knee joint afferent terminals: modulation by opioids. Brain Res 458:319–324

    Google Scholar 

  45. Zimny ML, Schutte M, Dabezies E (1986) Mechanoreceptors in the human anterior cruciate ligament. Anat Rec 214:204–209

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, University Hospital, University of Heidelberg, Schlierbacher Landstrasse 200a, D-69118, Heidelberg, Germany

    B. Fromm

  2. Institute of Anatomy and Cell Biology, Philipps-University, Marburg, Germany

    W. Kummer

Authors
  1. B. Fromm
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. Kummer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fromm, B., Kummer, W. Nerve supply of anterior cruciate ligaments and of cryopreserved anterior cruciate ligament allografts: a new method for the differentiation of the nervous tissues. Knee Surg, Sports traumatol, Arthroscopy 2, 118–122 (1994). https://doi.org/10.1007/BF01476484

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01476484

Key words

Search

Navigation