Histopathological Evaluation of the Anterior Cruciate Ligament in Patients With Advanced Gonarthrosis

Introduction: Knee osteoarthritis is a degenerative disease of the knee joint that leads to progressive loss of articular cartilage. There is only limited information in the literature on the degeneration of the anterior cruciate ligament (ACL) in patients with gonarthrosis. In this study, ACL samples excised during the surgery of patients undergoing total knee replacement (TKR) in 2019-2020 were evaluated histopathologically. The present study aims to investigate the relationship between the degeneration of the ACL and the stage of gonarthrosis. Methods: Direct X-rays of 47 patients undergoing knee arthroplasty were evaluated and stratified into two groups: Stage 3 (Group 1) and Stage 4 (Group 2). ACL samples were examined histopathologically. Staining was performed with hematoxylin-eosin (H&E), Alcian blue, and Masson's trichrome. The degree of degeneration was determined according to the Movin score and Bonar score. Based on these scores, the statistical significance of the relationship between the stage of gonarthrosis and histopathological examination results was evaluated. Results: When Group 1 patients were graded according to total Movin scores, the result was mild degeneration in 72.7% of the patients, while the corresponding rates were 76% in Group 2. None of the patients had a score reflecting severe degeneration. The total Bonar scores showed mild degeneration in 68.2% of Group 1 patients. In Group 2, the scores showed mild degeneration in 52% of the patients. No statistically significant difference was found between the groups in either scoring. Conclusion: It was determined that comparable degeneration occurred in the ACL with the progression of the stage of gonarthrosis.