Anterior cruciate ligament bundle insertions vary between ACL-rupture and non-injured knees

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2021-04, Vol.29 (4), p.1164-1172
• Main Authors: Dimitriou, Dimitris, Zou, Diyang, Wang, Zhongzheng, Helmy, Naeder, Tsai, Tsung-Yuan
• Format: Article
• Language: English
• Subjects: Adult; Anatomy; Anterior cruciate ligament; Anterior Cruciate Ligament - diagnostic imaging; Anterior Cruciate Ligament - pathology; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries - diagnostic imaging; Anterior Cruciate Ligament Injuries - pathology; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - methods; Female; Femur - diagnostic imaging; Femur - surgery; Finite element method; Humans; Image reconstruction; Imaging, Three-Dimensional - methods; Injuries; Insertion; Knee; Knee Injuries - diagnostic imaging; Knee Injuries - pathology; Knee Injuries - surgery; Knee Joint - diagnostic imaging; Knee Joint - surgery; Ligaments; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Retrospective Studies; Rupture; Rupturing; Surgery; Three dimensional models; Tibia - diagnostic imaging; Tibia - surgery; Topography; Young Adult
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-020-06122-1

Purpose The present study aimed to investigate the three-dimensional topographic anatomy of the anterior cruciate ligament (ACL) bundle attachment in both ACL-rupture and ACL-intact patients who suffered a noncontact knee injury and identify potential differences. Methods Magnetic resonance images of 90 ACL-rupture knees and 90 matched ACL-intact knees, who suffered a noncontact knee injury, were used to create 3D ACL insertion models. Results In the ACL-rupture knees, the femoral origin of the anteromedial (AM) bundle was 24.5 ± 9.0% posterior and 45.5 ± 10.5% proximal to the flexion–extension axis (FEA), whereas the posterolateral (PL) bundle origin was 35.5 ± 12.5% posterior and 22.4 ± 10.3% distal to the FEA. In ACL-rupture knees, the tibial insertion of the AM-bundle was 34.3 ± 4.6% of the tibial plateau depth and 50.7 ± 3.5% of the tibial plateau width, whereas the PL-bundle insertion was 47.5 ± 4.1% of the tibial plateau depth and 56.9 ± 3.4% of the tibial plateau width. In ACL-intact knees, the origin of the AM-bundle was 17.5 ± 9.1% posterior ( p