The Biology of the Normal ACL

Chapter

Abstract

The anterior cruciate ligament is an amazing and complex structure. The orchestration of proteins and cells to form a functional ligament that is capable of constantly fixing small injuries is truly amazing. In this chapter, we will briefly review the major structural components of this important ligament in an effort to set the stage for future chapters describing what happens after an ACL injury, how we might best restore the diverse population of cells and exquisitely complicated structure of this beautiful ligament, and how we may be able to utilize the biology to improve future clinical treatment options.

Keywords

Fibril 

Notes

Acknowledgement

 Research reported in this chapter was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Numbers RO1-AR052772, RO1-AR054099 and RO1-AR056834. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

References

  1. 1.
    Amiel D, Billings E, Akeson WH. Ligament structure, chemistry, and physiology. In: Daniel D, Akeson W, O’Connor J, editors. Knee ligaments: structure, function, injury and repair. New York: Raven Press; 1990. p. 77–91.Google Scholar
  2. 2.
    Amiel D, Frank C, Harwood F, Fronek J, Akeson W. Tendons and ligaments: a morphological and biochemical comparison. J Orthop Res. 1984;1(3):257–65.PubMedCrossRefGoogle Scholar
  3. 3.
    Arnoczky SP. Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res. 1983;172:19–25.PubMedGoogle Scholar
  4. 4.
    Frank CB, Woo S-Y, Andriacchi T, et al. Normal ligament: structure, function and composition. In: Woo S-Y, Buckwalter J, editors. Injury and repair of the musculoskeletal soft tissues. Park Ridge: American Academy of Orthopedic Surgeons; 1988.Google Scholar
  5. 5.
    Odensten M, Gillquist J. Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg. 1985;67(2):257–62.PubMedGoogle Scholar
  6. 6.
    Neuberger A, Slack HG. The metabolism of collagen from liver, bone, skin and tendon in the normal rat. Biochem J. 1953;53(1):47–52.PubMedGoogle Scholar
  7. 7.
    Minns RJ, Soden PD, Jackson DS. The role of the fibrous components and ground substance in the mechanical properties of biological tissues: a preliminary investigation. J Biomech. 1973;6(2):153–65.PubMedCrossRefGoogle Scholar
  8. 8.
    Woo SL, Buckwalter JA, editors. Injury and repair of the musculoskeletal soft tissues. Park Ridge: American Academy of Orthopedic Surgeons; 1988.Google Scholar
  9. 9.
    Masur SK, Dewal HS, Dinh TT, Erenburg I, Petridou S. Myofibroblasts differentiate from fibroblasts when plated at low density. Proc Natl Acad Sci USA. 1996;93(9):4219–23.PubMedCrossRefGoogle Scholar
  10. 10.
    Faryniarz DA, Chaponnier C, Gabbiani G, Yannas IV, Spector M. Myofibroblasts in the healing lapine medial collateral ligament: possible mechanisms of contraction. J Orthop Res. 1996;14(2):228–37.PubMedCrossRefGoogle Scholar
  11. 11.
    Murray MM, Martin SD, Martin TL, Spector M. Histological changes in the human anterior cruciate ligament after rupture. J Bone Joint Surg Am. 2000;82-A(10):1387–97.PubMedGoogle Scholar
  12. 12.
    Murray MM, Spector M. Fibroblast distribution in the anteromedial bundle of the human anterior cruciate ligament: the presence of alpha-smooth muscle actin-positive cells. J Orthop Res. 1999;17(1):18–27.PubMedCrossRefGoogle Scholar
  13. 13.
    Murray MM, Weiler A, Spindler KP. Interspecies variation in the fibroblast distribution of the anterior cruciate ligament. Am J Sports Med. 2004;32(6):1484–91.PubMedCrossRefGoogle Scholar
  14. 14.
    Alm A, Stromberg B. Vascular anatomy of the patellar and cruciate ligaments. A microangiographic and histologic investigation in the dog. Acta Chir Scand Suppl. 1974;445:25–35.PubMedGoogle Scholar
  15. 15.
    Halata Z, Wagner C, Baumann KI. Sensory nerve endings in the anterior cruciate ligament (Lig. cruciatum anterius) of sheep. Anat Rec. 1999;254(1):13–21.PubMedCrossRefGoogle Scholar
  16. 16.
    Johansson H, Sjolander P, Sojka P. A sensory role for the cruciate ligaments. Clin Orthop Relat Res. 1991;268:161–78.PubMedGoogle Scholar
  17. 17.
    Ruano-Gil D, Nardi-Vilardaga J, Tejedo-Mateu A. Influence of extrinsic factors on the development of the articular system. Acta Anat (Basel). 1978;101(1):36–44.CrossRefGoogle Scholar
  18. 18.
    Oakes BW, Carmichael GG. Proceedings: ultrastructural studies of the developing rat cruciate ligament using ruthenium red. J Anat. 1973;116(Pt 3):477–8.PubMedGoogle Scholar
  19. 19.
    Dahners LE, Sykes KE, Muller PR. A study of the mechanisms influencing ligament growth. Orthopedics. 1989;12(12):1569–72.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, Division of Sports MedicineBoston Children’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of OrthopedicsWarren Alpert Medical School of Brown University/Rhode Island HospitalProvidenceUSA

Personalised recommendations