2025 ISAKOS Biennial Congress ePoster
Comparison of Collagen-Type Composition by Layer and Physical Maturity in Quadriceps Tendons
Yushin Mizuno, MSc, PT, Kanazawa, Ishikawa JAPAN
Yasushi Takata, MD, PhD, Kanazawa, Ishikawa JAPAN
Yoshihiro Ishida, MD, Kahoku-Gun, Ishikawa JAPAN
Naoki Takemoto, MD, Kanazawa, Ishikawa JAPAN
Manase Nishimura, MD, Kanazawa, Ishikawa JAPAN
Takuya Sengoku, PT, PhD, Kanazawa JAPAN
Junsuke Nakase, MD, PhD, Kanazawa, Ishikawa JAPAN
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, JAPAN
FDA Status Not Applicable
Summary
Regarding the percentage of positive area for type I collagen in the quadriceps tendon (QT), in the first layer, the percentage was higher for samples obtained from patients with immature bodies than for those obtained from patients with mature bodies. However, there was no clear difference in QT at the same physical maturity level between the layers.
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Abstract
Introduction
Recently, the use of quadriceps tendon (QT) as the autograft has been attracting attention to reduce the re-operation rate after ACL reconstruction. Since the QT anatomically has a three-layered structure, there are two options when selecting the autograft: partial harvest of only first and second layers or full harvest of all layers. In addition, the percentages of type I collagen, the main component of tendon tissue, is related to the physical strength. The aim of this study was to determine the differences in the percentages of type I collagen by layer and physical maturity in the QT.
Methods
Forty-eight QT samples were obtained stratified from 16 patients who had undergone ACL reconstruction or other operation around knees. The obtained samples were divided into immature (< 20 years, >1.5 mm; 4 patients), young (< 20 years, < 1.5 mm; 7 patients), and adult (> 20 years; 5 patients) groups based on the age and the amount of the epiphyseal line of the patient. The amount of epiphyseal line was measured at the distal mid femur in the coronal section of MRI images. After appropriate processing, the samples were stained by immunohistochemical staining, and the percentages of positive area of type I and type III collagen were calculated using confocal microscopy and image analysis software. Based on the obtained results, comparisons between and within groups were made using one-way ANOVA, Kruskal Wallis test, two-way ANOVA, and Friedman test.
Results
The percentages of positive area (mean ± standard deviation) of type I collagen in the first layer was 98.5 ± 1.6% in the immature group, 84.0 ± 12.0% in the young group, and 89.8 ± 9.0% in the adult group, with significant differences only between the immature and young groups (p = .042). The positive rate in the second layer was 94.6 ± 10.2% for the immature group, 74.6 ± 13.9% for the young group, and 83.1 ± 17.5% for the adult group, and that in third layer was 76.6 ± 46.1% for the immature group, 69.9 ± 14.3 for the young group, and 85.7 ± 8.5% for the adult group. These values were not significantly different (p > .050). Within each group, the percentage of positive areas for type I collagen in all layers was similar (p > .050).
Conclusion
These results suggest that QT may be a suitable choice for ACL reconstruction with a reduced re-operation rate, especially for immature patients. Furthermore, there may be no clinically significant difference between using partial and full layers in terms of the percentage of type I collagen types, since there was no obvious difference in the third layer from the other layers.