2025 ISAKOS Biennial Congress ePoster
Age-Related Changes In The Ultrastructure Of The Quadriceps Tendon
Yoshihiro Ishida, MD, Kahoku-Gun, Ishikawa JAPAN
Junsuke Nakase, MD, PhD, Kanazawa, Ishikawa JAPAN
Yasushi Takata, MD, PhD, Kanazawa, Ishikawa JAPAN
Naoki Takemoto, MD, Kanazawa, Ishikawa JAPAN
Manase Nishimura, MD, Kanazawa, Ishikawa JAPAN
Takuya Sengoku, PT, PhD, Kanazawa JAPAN
Yushin Mizuno, MSc, PT, Kanazawa, Ishikawa JAPAN
Kanazawa university, kanazawa, Ishikawa, JAPAN
FDA Status Not Applicable
Summary
The diameter of collagen fibrils in the quadriceps tendon increases with age, but becomes thinner in elderly people. In elderly people, collagen fibrils are reduced to two-thirds of those in adults.
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Abstract
Introduction
In recent years, the quadriceps tendon (QT) has attracted attention as a graft tendon for anterior cruciate ligament (ACL) reconstruction. The strength advantage of QT is based on the fact that the ultrastructural collagen fibril diameter is larger in children than in the semitendinosus tendon. QT collagen fibril diameter is known to increase with growth from birth to adulthood, but it is unclear how fibril diameter changes in the elderly. There is currently no clear consensus regarding the appropriate age and age-specific selection of tendon grafts for ACL reconstruction surgery, however, to select the optimal treatment option, orthopedic surgeons must consider graft stability and durability as well as age-related tissue changes. The purpose of this study was to investigate age-related changes in QT collagen fibril diameter.
Methods
The subjects were 24 patients who underwent ACL reconstruction, medial patellofemoral ligament reconstruction, total knee arthroplasty, and osteochondral column grafting. QT tissues collected during the surgery were used as specimens and analyzed using a transmission electron microscope. The diameter of collagen fibrils was observed, and each group of 6 people was examined: immature group (11.5 ± 1.6 years), young group (15.8 ± 1.0 years), adult group (29.8 ± 11.3 years), and elderly group (70.3 ± 9.7 years). The average fibril diameter was calculated for each sample. The smallest collagen fibril diameter was measured down to 0.1 mm using Image J software (National Institutes of Health, Bethesda, MD, USA). At least four slides were counted from each specimen, and at least 200 collagen fibrils were present in each slide. The average number of collagen fibrils measured per specimen was 812 ± 10. The four groups were statistically analyzed using one-way analysis of variance and Tukey's test.
Results
The average collagen fibril diameter was 89.7 ± 14.4 nm, 94.8 ± 16.4 nm, and 107.2 ± 12.1 nm in the immature, young, and adult groups, respectively, and 73.0 ± 9.7 nm in the elderly group. Although no significant difference was observed between the immature and young groups, the fibril diameter in the adult group was significantly larger than the immature and young group, and the fibril diameter in the elderly group was significantly smaller than the other three groups.
Conclusion
The average fibril diameter of QT collagen increased with growth, but the average fibril diameter of elderly group decreased than that of other group.