ArticleBiomedicines2024
Do the Differences in the Epiligament of the Proximal and Distal Parts of the Anterior Cruciate Ligament Explain Their Different Healing Capacities? Quantitative and Immunohistochemical Analysis of CD34 and α-SMA Expression in Relation to the Epiligament Theory.
Article in Biomedicines, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 11 citations in OpenAlex.
- Differential Arterial Supply of the ACL and PCL Revealed by 7T-qMRI, Histology, and Micro-CT.Orthopaedic journal of sports medicine · 2026Article
- Clinical Effectiveness and Magnetic Resonance Imaging-Based Endurability of Matrix-Associated Autologous Chondrocyte Implantation with an Autologous Periosteal Flap for Articular Cartilage Defects of the Knee Joint.Journal of clinical medicine · 2026Article
- Regional Expression of Vimentin, S100, and Epithelial Membrane Antigen in the Human Medial Collateral Ligament: A Robust Two-Way Analysis of Variance.Journal of functional morphology and kinesiology · 2026Article
- Contraindications to Lateral Extra-Articular Tenodesis: A Systematic Review.Journal of clinical medicine · 2026Review
- Age and Time to Surgery Are Associated with Concomitant Meniscal Injuries in Adolescent ACL Tears: A Retrospective Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Combined ACL and ALL Reconstruction Using Allografts as the ACL Graft Source Reduces Surgical Failure and Improves Graft Maturity Compared with Isolated ACL Reconstruction.Journal of clinical medicine · 2026Article
- Can the Spatial Heterogeneity in the Epiligament Explain the Differential Healing Capacities of the ACL and MCL?Journal of clinical medicine · 2026Article
- Evaluating Tibial Tunnel Landmarks in Anterior Cruciate Ligament Reconstruction: Remnant Versus Lateral Meniscus Anterior Horn.Journal of clinical medicine · 2025Article
- Technical Details of Lateral Tenodesis at the Fascia Lata: A Systematic Review of the Literature.Journal of clinical medicine · 2025Review
- The Effect of IL-17A and Combined Mechanical Injury on Meniscal Tissue Integrity In Vitro.Journal of clinical medicine · 2025Article
- Advances in Research on Brain Structure and Activation Characteristics in Patients with Anterior Cruciate Ligament Reconstruction: A Systematic Review.Brain sciences · 2025Review
- Comparison of cellular activity and gene expression in repaired versus reconstructed anterior cruciate ligaments: A case-control study.Journal of experimental orthopaedics · 2025Article
- The Risk of Secondary Knee Procedures After Anterior Cruciate Ligament Reconstruction-A Nationwide Retrospective Cohort Study.Journal of clinical medicine · 2025Article
- Should We Accept the Epiligament Theory About the Differences in the Healing Potential of the Medial Collateral and the Anterior Cruciate Ligament?Biomedicines · 2025Article
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Authors and funding
10 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this study was to assess the epiligament theory by determining the normal epiligament morphology of the proximal and distal parts of the anterior cruciate ligament in humans and analyzing the differences between them and the midportion of the ligament in terms of cell numbers and expression of CD34 and α-SMA. Samples were obtained from the anterior cruciate ligaments of 12 fresh knee joints. Monoclonal antibodies against CD34 and α-SMA were used for immunohistochemistry. Photomicrographs were analyzed using ImageJ software, version 1.53f. The cell density was higher in the epiligament than in the ligament connective tissue. Cell counts were higher in the proximal and distal thirds than in the midsubstance of the epiligament. CD34 was expressed similarly in the proximal and distal thirds, although it seemed slightly more pronounced in the distal third. α-SMA expression was more robust in the proximal than the distal part. The results revealed that CD34 and α-SMA are expressed in the human epiligament. The differences between the numbers of cells in the proximal and distal parts of the epiligament and the expression of CD34 and α-SMA enhance epiligament theory. Future investigations into improving the quality of ligament healing should not overlook the epiligament theory.
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