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Evaluation of the Angle Between the Long Axis of the Femoral Anterior Cruciate Ligament Footprint and Bony Morphology of the Knee: A Cadaveric Descriptive Study

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Abstract

Purpose

There have been numerous studies of the anterior cruciate ligament (ACL) anatomy, but few have focused on the long axis angle of the femoral ACL footprint. This study investigated the angle between the long axis of the femoral ACL footprint and the bony morphology of the knee.

Methods

This study is a cadaveric descriptive study. Thirty non-paired formalin-fixed knees of Japanese cadavers were used. Anteromedial (AM) and posterolateral (PL) bundles were identified according to the tension pattern differences during the complete range of motion of the knee. In the ACL femoral footprint, there is a fold between the mid-substance insertion site and fan-like extension fibers. After identifying AM and PL bundles of mid-substance fibers, the mid-substance and fan-like extension fibers were divided into those bundles and stained. We defined the line passing through the center of the AM and PL bundles as the long axis of the ACL. The center points of each of the four areas and the angle between the long axis of the ACL and the bony morphology of the knee were calculated using Image J software.

Results

The mean angle between the axis of the femoral shaft and the long axis of the ACL mid-substance insertion was 28.8 ± 12.2 degrees. The mean angle between the Blumensaat line and the long axis of the mid-substance was 54.2 ± 13.5 degrees.

Conclusion

The mean angle between the axis of the femoral shaft and the long axis of the femoral ACL footprint was approximately 29 degrees. There is a wide variation in the long axis of the femoral ACL footprint. To achieve better clinical results through a more anatomically accurate reconstruction, it can be beneficial to replicate the ACL femoral footprint along its native long axis.

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Data availability

Inclusion of data is available in this study.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nihon University Hospital, 1-6, Kanda-Surugadai, Chiyoda-Ku, Tokyo, Japan

    Makoto Suruga

  2. Kamimoku Hot Springs Hospital, Ishikura, 198-2, Minakami, Gunma, Japan

    Takanori Iriuchishima

  3. Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, 30-1, Oyaguchi Kamicho, Itabashi-Ku, Tokyo, Japan

    Yoshiyuki Yahagi, Genki Iwama & Kazuyoshi Nakanishi

  4. B&J Clinic Ochanomizu, 2-1-47 Kanda Surugadai, Chiyoda-Ku, Tokyo, Japan

    Takashi Horaguchi

  5. Department of Functional Morphology, Nihon University School of Medicine, 30-1, Oyaguchi Kamicho, Itabashi-Ku, Tokyo, Japan

    Shin Aizawa & Shuichi Hirai

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  1. Makoto Suruga
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Correspondence to Makoto Suruga.

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Suruga, M., Iriuchishima, T., Yahagi, Y. et al. Evaluation of the Angle Between the Long Axis of the Femoral Anterior Cruciate Ligament Footprint and Bony Morphology of the Knee: A Cadaveric Descriptive Study. JOIO 58, 510–516 (2024). https://doi.org/10.1007/s43465-024-01131-5

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