Abstract
Recently, the femoral attachments of anteromedial and posterolateral bundles of anterior cruciate ligament (ACL) have been extensively discussed, however, few publications have mentioned radiographic measurements of the tibial insertions of two bundles. The aim of this study is to determine the radiographic measurements of the tibial sagital insertions for anteromedial (AM) and posterolateral (PL) bundles of ACL. Thirty-one cadaveric proximal tibias were used. After identification of the AM and PL bundles insertion sites on the tibia, the insertion center and the other anatomic landmarks were marked with a lead pin, and lateral radiographs were taken. Sagital percentage is a percentage of the location of the insertion point calculated from the anterior margin of the tibia in the anteroposterior direction. Anterior edge of ACL averaged 25.0%, center of AM averaged 34.6%, center of PL averaged 38.4%, posterior edge of ACL averaged 50.2%. This study defines the radiographic location of the tibial insertions of the anteromedial and posterolateral bundles of ACL. This contributes to more precise evaluation of anatomical double bundle ACL reconstruction surgery postoperatively.
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References
Amis AA, Scammell BE (1993) Biomechanics of intra-articular and extra-articular reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 75:812–817
Amis AA, Jakob RP (1998) Anterior cruciate ligament graft positioning, tensioning and twisting. Knee Surg Sports Traumatol Arthrosc 6(Suppl 1):S2–S12
Arms SW, Pope MH, Johnson RJ, Fischer RA, Arvidsson I, Eriksson E (1984) The biomechanics of anterior cruciate ligament rehabilitation and reconstruction. Am J Sports Med 12:8–18
Colombet P, Robinson J, Christel P, Franceschi JP, Djian P, Bellier G et al (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22:984–992
Edwards A, Bull AM, Amis AA (2007) The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament: part 1. Tibial attachment. Knee Surg Sports Traumatol Arthrosc 15:1414–1421
Furman W, Marshall JL, Girgis FG (1976) The anterior cruciate ligament. A functional analysis based on postmortem studies. J Bone Joint Surg Am 58:179–185
Fuss FK (1991) Anatomy and function of the cruciate ligaments of the domestic pig (Sus scrofa domestica): a comparison with human cruciates. J Anat 178:11–20
Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231
Giron F, Cuomo P, Edwards A, Bull AM, Amis AA, Aglietti P (2007) Double-bundle “anatomic” anterior cruciate ligament reconstruction: a cadaveric study of tunnel positioning with a transtibial technique. Arthroscopy 23:7–13
Hoogland T, Hillen B (1984) Intra-articular reconstruction of the anterior cruciate ligament. An experimental study of length changes in different ligament reconstructions. Clin Orthop Relat Res 185:197–202
Hutchinson MR, Bae TS (2001) Reproducibility of anatomic tibial landmarks for anterior cruciate ligament reconstructions. Am J Sports Med 29:777–780
Johnson RJ, Beynnon BD, Nichols CE, Renstrom PA (1992) The treatment of injuries of the anterior cruciate ligament. J Bone Joint Surg Am 74:140–151
Odensten M, Gillquist J (1985) Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am 67:257–262
Odensten M, Gillquist J (1986) A modified technique for anterior cruciate ligament (ACL) surgery using a new drill guide for isometric positioning of the ACL. Clin Orthop Relat Res 213:154–158
Shea KG, Apel PJ, Pfeiffer RP, Showalter LD, Traughber PD (2002) The tibial attachment of the anterior cruciate ligament in children and adolescents: analysis of magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 10:102–108
Stäubli HU, Rauschning W (1994) Tibial attachment area of the anterior cruciate ligament in the extended knee position. Anatomy and cryosections in vitro complemented by magnetic resonance arthrography in vivo. Knee Surg Sports Traumatol Arthrosc 2:138–146
Takahashi M, Doi M, Abe M, Suzuki D, Nagano A (2006) Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament. Am J Sports Med 34:787–792
Zantop T, Wellmann M, Fu FH, Petersen W (2008) Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstruction: anatomic and radiographic findings. Am J Sports Med 36:65–72
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Doi, M., Takahashi, M., Abe, M. et al. Lateral radiographic study of the tibial sagital insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 17, 347–351 (2009). https://doi.org/10.1007/s00167-008-0668-x
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DOI: https://doi.org/10.1007/s00167-008-0668-x