Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees

Verfasser / Beitragende:
[Robert Śmigielski, Urszula Zdanowicz, Michał Drwięga, Bogdan Ciszek, Beata Ciszkowska-Łysoń, Rainer Siebold]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/11(2015-11-01), 3143-3150
Format:
Artikel (online)
ID: 605460663
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024 7 0 |a 10.1007/s00167-014-3146-7  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-3146-7 
245 0 0 |a Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees  |h [Elektronische Daten]  |c [Robert Śmigielski, Urszula Zdanowicz, Michał Drwięga, Bogdan Ciszek, Beata Ciszkowska-Łysoń, Rainer Siebold] 
520 3 |a Purpose: Recently, the configuration of the anterior cruciate ligament (ACL) from its direct femoral insertion to midsubstance was found to be flat. This might have an important impact for anatomical ACL reconstruction. The purpose of this anatomical study was to evaluate the macroscopic appearance of the ACL from femoral to midsubstance. Methods: The ACL was dissected in 111 human fresh frozen cadaver knees from its femoral insertion to midsubstance, and the shape was described. The anatomical findings were documented on digital photographs and on video. Thirty knees were sent for computed tomography (CT), magnetic resonance imaging (MRI) and histology of the femoral ACL insertion. Results: Two millimetres from its direct femoral insertion, the ACL fibres formed a flat ribbon in all dissected knees without a clear separation between AM and PL bundles. The ribbon was in exact continuity of the posterior femoral cortex. The width of the ribbon was between 11.43 and 16.18mm and the thickness of the ACL was only 2.54-3.38mm. 3D CT, MRI and the histological examination confirmed above findings. Conclusion: This is a detailed anatomical study describing the ribbon-like structure of the ACL from its femoral insertion to midsubstance. A key point was to carefully remove the surface fibrous membrane of the ACL. A total of 2-3mm from its bony femoral insertion, the ACL formed a flat ribbon without a clear separation between AM and PL bundles. The ribbon was in exact continuity of the posterior femoral cortex. The findings of a flat ligament may change the future approach to femoral ACL footprint and midsubstance ACL reconstruction and to graft selection. 
540 |a The Author(s), 2014 
690 7 |a Ribbon  |2 nationallicence 
690 7 |a Anterior cruciate ligament  |2 nationallicence 
690 7 |a ACL  |2 nationallicence 
690 7 |a Femoral insertion  |2 nationallicence 
690 7 |a Intraligamentous  |2 nationallicence 
690 7 |a Midsubstance  |2 nationallicence 
690 7 |a Anatomy  |2 nationallicence 
700 1 |a Śmigielski  |D Robert  |u Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
700 1 |a Zdanowicz  |D Urszula  |u Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
700 1 |a Drwięga  |D Michał  |u Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
700 1 |a Ciszek  |D Bogdan  |u Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Chalbinskiego 5, 02-004, Warsaw, Poland  |4 aut 
700 1 |a Ciszkowska-Łysoń  |D Beata  |u Department of Radiology, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
700 1 |a Siebold  |D Rainer  |u Institute for Anatomy and Cell Biology, INF, Ruprecht-Karls University Heidelberg, Heidelberg, Germany  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/11(2015-11-01), 3143-3150  |x 0942-2056  |q 23:11<3143  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-3146-7  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-3146-7  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Śmigielski  |D Robert  |u Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zdanowicz  |D Urszula  |u Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Drwięga  |D Michał  |u Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ciszek  |D Bogdan  |u Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Chalbinskiego 5, 02-004, Warsaw, Poland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ciszkowska-Łysoń  |D Beata  |u Department of Radiology, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Siebold  |D Rainer  |u Institute for Anatomy and Cell Biology, INF, Ruprecht-Karls University Heidelberg, Heidelberg, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/11(2015-11-01), 3143-3150  |x 0942-2056  |q 23:11<3143  |1 2015  |2 23  |o 167