Flat midsubstance of the anterior cruciate ligament with tibial -C-shaped insertion siteReportar como inadecuado




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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 11, pp 3136–3142

First Online: 20 May 2014Received: 19 January 2014Accepted: 02 May 2014

Abstract

PurposeThis anatomical cadaver study was performed to investigate the flat appearance of the midsubstance shape of the anterior cruciate ligament ACL and its tibial -C-shaped insertion site.

MethodsThe ACL midsubstance and the tibial ACL insertion were dissected in 20 cadaveric knees n = 6 fresh frozen and n = 14 paraffined. Magnifying spectacles were used for all dissections. Morphometric measurements were performed using callipers and on digital photographs.

ResultsIn all specimens, the midsubstance of the ACL was flat with a mean width of 9.9 mm, thickness of 3.9 mm and cross-sectional area of 38.7 mm. The -direct-C-shaped tibial insertion runs from along the medial tibial spine to the anterior aspect of the lateral meniscus. The mean width length of the -C- was 12.6 mm, its thickness 3.3 mm and area 31.4 mm. The centre of the -C- was the bony insertion of the anterior root of the lateral meniscus overlayed by fat and crossed by the ACL. No posterolateral PL inserting ACL fibres were found. Together with the larger -indirect- part area 79.6 mm, the -direct- one formed a -duck-foot-shaped footprint.

ConclusionThe tibial ACL midsubstance and tibial -C-shaped insertion are flat and are resembling a -ribbon-. The centre of the -C- is the bony insertion of the anterior root of the lateral meniscus. There are no central or PL inserting ACL fibres. Anatomical ACL reconstruction may therefore require a flat graft and a -C-shaped tibial footprint reconstruction with an anteromedial bone tunnel for single bundle and an additional posteromedial bone tunnel for double bundle.

KeywordsACL Flat Ribbon Tibial insertion -C-shaped Midsubstance An erratum to this article can be found at http:-dx.doi.org-10.1007-s00167-014-3230-z.

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Autor: Rainer Siebold - Peter Schuhmacher - Francis Fernandez - Robert Śmigielski - Christian Fink - Axel Brehmer - Joachim Kirsc

Fuente: https://link.springer.com/







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