Dimitris Dimitriou1, Diyang Zou2,3, Zhongzheng Wang2,3, Naeder Helmy1, Tsung-Yuan Tsai4,5. 1. Department of Orthopedics, Bürgerspital Solothurn, Schöngrünstrasse 42, Solothurn, 4500, Switzerland. 2. Shanghai Key Laboratory of Orthopaedic Implants and Clinical Translational R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; School of Biomedical Engineering and Med.X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, China. 3. Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, 200030, Shanghai, China. 4. Shanghai Key Laboratory of Orthopaedic Implants and Clinical Translational R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; School of Biomedical Engineering and Med.X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, China. tytsai@sjtu.edu.cn. 5. Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, 200030, Shanghai, China. tytsai@sjtu.edu.cn.
Abstract
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 < 0.01) and 42.3 ± 10.5% proximal (n.s.) to the FEA, whereas the PL-bundle origin was 32.1 ± 11.1% posterior (n.s.) and 16.3 ± 9.4% distal (p < 0.01) to the FEA. In ACL-intact knees, the insertion of the AM-bundle was 34.4 ± 6.6% of the tibial plateau depth (n.s.) and 48.1 ± 4.6% of the tibial plateau width (n.s.), whereas the PL-bundle insertion was 42.7 ± 5.4% of the tibial plateau depth (p < 0.01) and 57.1 ± 4.8% of the tibial plateau width (n.s.). CONCLUSION: The current study revealed variations in the three-dimensional topographic anatomy of the native ACL between ACL-rupture and ACL-intact knees, which might help surgeons who perform anatomical double-bundle reconstruction surgery. LEVEL OF EVIDENCE: III.
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 < 0.01) and 42.3 ± 10.5% proximal (n.s.) to the FEA, whereas the PL-bundle origin was 32.1 ± 11.1% posterior (n.s.) and 16.3 ± 9.4% distal (p < 0.01) to the FEA. In ACL-intact knees, the insertion of the AM-bundle was 34.4 ± 6.6% of the tibial plateau depth (n.s.) and 48.1 ± 4.6% of the tibial plateau width (n.s.), whereas the PL-bundle insertion was 42.7 ± 5.4% of the tibial plateau depth (p < 0.01) and 57.1 ± 4.8% of the tibial plateau width (n.s.). CONCLUSION: The current study revealed variations in the three-dimensional topographic anatomy of the native ACL between ACL-rupture and ACL-intact knees, which might help surgeons who perform anatomical double-bundle reconstruction surgery. LEVEL OF EVIDENCE: III.
Authors: Louis E Defrate; Ramprasad Papannagari; Thomas J Gill; Jeremy M Moses; Neil P Pathare; Guoan Li Journal: Am J Sports Med Date: 2006-04-24 Impact factor: 6.202
Authors: Matthew Daggett; Andrew C Ockuly; Matthew Cullen; Kyle Busch; Christian Lutz; Pierre Imbert; Bertrand Sonnery-Cottet Journal: Arthroscopy Date: 2015-12-23 Impact factor: 4.772