Morphological features of fascia lata in relation to fascia diseases

Abstract

Fascia lata is an important element of the fascial system, which forms the continuum of connective tissue throughout the body. This deep fascia envelops the entire thigh and hip area and its main function is to transmit mechanical forces generated by the musculoskeletal system of the lower extremities. Fascia lata is also known as a useful and easily harvested graft material. Despite its crucial role in lower extremity biomechanics and wide-ranging applications in plastic and reconstructive surgery, both the structure of fascia lata and particularly the cells populating this tissue are relatively unexplored and therefore poorly understood. The aim of this study was to characterize the main cell populations encountered within human fascia lata and to try to understand their role in health and diseases. Pathologically unchanged human fascia lata was obtained post mortem from adult males. The specimens were analyzed under light, electron, and confocal microscopy. On the basis of different visualization techniques, we were able to characterize in detail the cells populating human fascia lata. The main cells found were fibroblasts, fibrocytes, mast cells, cells showing myoid differentiation, nerve cells, and most interestingly, telocytes. Our results supplement the formerly inadequate information in the literature regarding the cellular components of deep fascial structure, may contribute to a better understanding of the pathogenesis of fascial disorders and improve fascia lata application as a graft material.

The Waterfall Fascia Lata Interposition Arthroplasty “Grika Technique” as Treatment of Posttraumatic Osteoarthritis of the Elbow in a High-Demand Adult Patient: Validity and Reliability

“…The high collagen content seems to be a rational choice for grafting into osteoarthritic joints. The flap of the fascia lata, used by Putti and in our technique, has a considerable similarity with the small intestinal submucosa and decellularized dermis [ 1 , 14 , 15 ].…”

Migrating Myofibroblastic Iliotibial Band-Derived Fibroblasts Represent a Promising Cell Source for Ligament Reconstruction

“…Advantages of ITB tissue for the purpose of surgical defect reconstruction include the high density of connective tissue fibers and the ease of surgical harvest. Despite these advantages of the autograft and its broad field of application in reconstructive medicine such as anterior cruciate ligament (ACL) reconstruction, both the histological structure and the cellular component of the ITB are poorly understood [5,12]. It is known that ACLs contain myofibroblasts expressing alpha smooth muscle actin (αSMA) [13].…”

“…It is known that ACLs contain myofibroblasts expressing alpha smooth muscle actin (αSMA) [13]. αSMA-positive cells have been shown in the fascia lata [12]; however, the presence of myofibroblasts in ITB tissue is mainly unknown. In addition, their role in the ligaments is controversially discussed: Myofibroblasts of the ligaments are involved in various processes such as healing and repair [13], fibrosis [14,15], as well as ACL tissue degeneration [16].…”

“…In the past, explant and organ cultures of tendons of various origins, such as birds or mammals, have provided important information on the growth, metabolism, collagen formation, and response to injury [20]. However, the ITB fibroblasts are barely characterized [12]. To date, cultured explants have been used as testing systems to assess the effects of various agents and conditions [21,22,23,24,25].…”

New Proposal to Define the Fascial System

“…Through these contacts, they are able to influence the metabolic environment and play a part in repair and remodeling/reshaping processes. The exact role of these cells in the fascia is still unknown [24,25,26]. …”