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The difference in centre position in the ACL femoral footprint inclusive and exclusive of the fan-like extension fibres

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to compare the centre position of each anterior cruciate ligament bundle in its femoral footprint in measurements including and excluding the fan-like extension fibres.

Methods

Fourteen non-paired human cadaver knees were used. All soft tissues around the knee were resected except the ligaments. The ACL was divided into antero-medial (AM) and postero-lateral (PL) bundles according to the difference in tension patterns. The ACL was carefully dissected, and two outlines were made of the periphery of each bundle insertion site: those which included and those which excluded the fan-like extension fibres. An accurate lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The centre position of each bundle, including and excluding the fan-like extension fibres, was measured with ImageJ software (National Institution of Health). Evaluation of the centre position was performed using the modified quadrant method.

Results

The centre of the femoral AM bundle including the fan-like extension was located at 28.8 % in a shallow-deep direction and 37.2 % in a high-low direction. When the AM bundle was evaluated without the fan-like extension, the centre was significantly different at 34.6 % in a shallow-deep direction (p = 0.000) and 36 % in a high-low direction. The centre of the PL bundle including the fan-like extension was found at 37.1 % in a shallow-deep direction and 73.4 % in a high-low direction. When the PL bundle was evaluated without the fan-like extension, the centre was significantly different at 42.7 % in a shallow-deep direction (p = 0.000) and 69.3 % in a high-low direction (p = 0.000).

Conclusion

The centre position of the AM and PL bundles in the femoral ACL footprint was significantly different depending on the inclusion or exclusion of the fan-like extension fibres. For the clinical relevance, to reproduce the direct femoral insertion in the anatomical ACL reconstruction, tunnels should be placed relatively shallow and high in the femoral ACL footprint.

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Abbreviations

ACL:

Anterior cruciate ligament

AM:

Antero-medial bundle

PL:

Postero-lateral bundle

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kamimoku Hot Springs Hospital, Minakami, Japan

    Takanori Iriuchishima

  2. Department of Orthopaedic Surgery, Nihon University Hospital, Tokyo, Japan

    Keinosuke Ryu

  3. Department of Functional Morphology, Nihon University School of Medicine, Tokyo, Japan

    Shin Aizawa

  4. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburg, PA, USA

    Freddie H. Fu

Authors
  1. Takanori Iriuchishima
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  2. Keinosuke Ryu
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  3. Shin Aizawa
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  4. Freddie H. Fu
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Correspondence to Takanori Iriuchishima.

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Iriuchishima, T., Ryu, K., Aizawa, S. et al. The difference in centre position in the ACL femoral footprint inclusive and exclusive of the fan-like extension fibres. Knee Surg Sports Traumatol Arthrosc 24, 254–259 (2016). https://doi.org/10.1007/s00167-014-3373-y

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