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Ultrastructural study of the extra-articular Leeds-Keio ligament prosthesis

¹ Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, Kawasaki-ku, Kawasaki 210-0013, Japan
² Department of Orthopaedic Surgery, Isehara-kyodo Hospital, Isehara, 259-1132, Japan
³ Department of Pathology, Kawasaki Municipal Hospital

Correspondence to:
Dr E Nomura
Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki 210-0013, Japan; edk-nomura{at}spn1.speednet.ne.jp
ABSTRACT
Background: There have been several histological studies of the Leeds-Keio ligament in anterior cruciate ligament reconstruction, but there have been few of the Leeds-Keio ligament in the extra-articular portion.

Aims/Methods: To report the histological and ultrastructural findings of two cases of medial patellofemoral ligament reconstruction using the Leeds-Keio ligament, removed 6.1 years and 8.7 years after implantation.

Results: In both cases, the tissue over the Leeds-Keio ligament was a ligament-like tissue. Electron microscopy showed that the diameter of the collagen fibrils in the tissue over the Leeds-Keio ligament was unimodal in the case investigated 6.1 years after implantation but bimodal in the case investigated after 8.7 years.

Conclusions: The tissue over the Leeds-Keio ligament may continue to grow with prolonged periods of mechanical stress.

Abbreviations: LK, Leeds-Keio; MPFL, medial patellofemoral ligament

Keywords: reconstructed ligament; collagen fibril; diameter; electron microscopy