caa a22 4500 605460663 CHVBK 20210128100239.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00167-014-3146-7 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3146-7 Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees [Elektronische Daten] [Robert Śmigielski, Urszula Zdanowicz, Michał Drwięga, Bogdan Ciszek, Beata Ciszkowska-Łysoń, Rainer Siebold] 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. The Author(s), 2014 Ribbon nationallicence Anterior cruciate ligament nationallicence ACL nationallicence Femoral insertion nationallicence Intraligamentous nationallicence Midsubstance nationallicence Anatomy nationallicence Śmigielski Robert Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut Zdanowicz Urszula Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut Drwięga Michał Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut Ciszek Bogdan Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Chalbinskiego 5, 02-004, Warsaw, Poland aut Ciszkowska-Łysoń Beata Department of Radiology, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut Siebold Rainer Institute for Anatomy and Cell Biology, INF, Ruprecht-Karls University Heidelberg, Heidelberg, Germany aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3143-3150 0942-2056 23:11<3143 2015 23 167 https://doi.org/10.1007/s00167-014-3146-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3146-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Śmigielski Robert Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut NATIONALLICENCE 700 1- Zdanowicz Urszula Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut NATIONALLICENCE 700 1- Drwięga Michał Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut NATIONALLICENCE 700 1- Ciszek Bogdan Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Chalbinskiego 5, 02-004, Warsaw, Poland aut NATIONALLICENCE 700 1- Ciszkowska-Łysoń Beata Department of Radiology, Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland aut NATIONALLICENCE 700 1- Siebold Rainer Institute for Anatomy and Cell Biology, INF, Ruprecht-Karls University Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3143-3150 0942-2056 23:11<3143 2015 23 167