Comparative Study of the Size and Shape of Human Anterior and Posterior Cruciate Ligaments (original) (raw)
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The Human Posterior Cruciate Ligament Complex: An Interdisciplinary Study
The American Journal of Sports Medicine, 1995
To study the structural and functional properties of the human posterior cruciate ligament complex, we meas ured the cross-sectional shape and area of the anterior cruciate, posterior cruciate, and meniscofemoral liga ments in eight cadaveric knees. The posterior cruciate ligament increased in cross-sectional area from tibia to femur, and the anterior cruciate ligament area de creased from tibia to femur. The meniscofemoral liga ments did not change shape in their course from the lateral meniscus to their femoral insertions. The pos terior cruciate ligament cross-sectional area was ap proximately 50% and 20% greater than that of the an terior cruciate ligament at the femur and tibia, respectively. The meniscofemoral ligaments averaged approximately 22% of the entire cross-sectional area of the posterior cruciate ligament. The insertion sites of the anterior and posterior cruciate ligaments were evalu ated. The insertion sites of the anterior and posterior cruciate ligaments were 300...
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2013
The purpose of this study was to evaluate the shape of the native anterior cruciate ligament (ACL) along its length in relation to the posterior cruciate ligament (PCL) and compare it with the size of the 3 commonly used autografts (boneepatellar tendonebone [BPTB], single-bundle hamstring, and double-bundle hamstring). Methods: With the knee in extension, we filled the intercondylar notch with paraffin, fixing the cruciate ligaments in their natural position, in 8 cadaveric specimens. The ACL-PCL tissue specimen, embedded in paraffin, was removed en bloc. Gross sections were prepared in the coronal plane and were evaluated histologically. The width, thickness, and cross-sectional area of both the ACL and PCL were determined. The dimensions of the semitendinosus tendon (ST), gracilis tendon (GT), and BPTB grafts were measured and compared with those of the native ACL. Results: The PCL occupies the largest part of the intercondylar area, leaving only a small space for the ACL in knee extension. The ACL midsubstance has a width of 5 mm, resembling a band shape. Only before its tibial insertion does the ACL fan out and take the form of its tibial attachment. The BPTB graft has a thickness of 5.8 mm, whereas the ST and GT grafts have a thickness of 6.25 mm and 4.5 mm, respectively, and are comparable to the midsubstance of the ACL but undersized in the tibial insertion (P ¼ .0016 for BPTB graft, P ¼ .002 for ST graft, and P ¼ .0003 for GT graft). A quadruple-looped ST-GT graft, with a diameter of 8 mm, is oversized in the midsubstance (P ¼ .0002) but fits better in the tibial attachment. Conclusions: The ACL midsubstance has a width of 5 mm, resembling a band shape. Before its tibial insertion, the ACL fans out like a trumpet, taking the form of its wide tibial attachment. Clinical Relevance: The dimensions of the native ACL have to be considered in graft selection for anatomic ACL reconstruction.
The posterior meniscofemoral ligament: Morphologic study and anatomic classification
Clinical Anatomy, 2011
The meniscofemoral ligaments (MFLs) run from the medial femoral condyle to the posterior horn of the lateral meniscus and consist of anterior MFL (aMFL) and/or posterior MFL (pMFL) components according to whether it passes anterior or posterior to the posterior cruciate ligament (PCL). The purpose of this study was to analyze the incidence and morphologic features of the MFLs in Koreans and formulate an anatomic classification system of MFLs to aid the detailed interpretation of medical imaging or biomechanical data. One hundred knees from 52 cadavers were studied. Eighty-seven knees had pMFLs, whereas an aMFL was only found in one knee from a male cadaver. The pMFLs and PCLs were longer in males than in females (P < 0.05). The most common type of MFL was the high crossing of a typical pMFL against the PCL in both genders. Regarding other types, the incidence of absent pMFLs was higher in males than in females and the oblique bundle of the PCL was easily confused with the pMFL in several cases in both genders. These results provide the basis for the classification system of the MFL and will contribute to better outcomes for evaluating the MFL and PCL when using medical imaging such as arthro-CT scan or MRI through a better understanding of the anatomy of the MFL and
Anatomic Relation Between the Posterior Cruciate Ligament and the Joint Capsule
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 2008
The aim of this anatomic study on cadavers was to determine the anatomic relation between the posterior cruciate ligament (PCL) and the posterior joint capsule attachment. Methods: Thirty knees were dissected by means of a posterior approach to the knee. The presence of the posterior popliteal ligament and Wrisberg meniscofemoral ligament was observed and a U-shaped capsulotomy was performed while preserving the distal insertion of the ligament. After detaching the PCL and determining its area on the tibia, we determined its geometric center and posterior margin and measured the distances between the tibial insertion of the capsule and these points. Results: The distance between the center of the PCL and the posterior capsule was 10.3 mm, and the distance between the posterior margin of the PCL and the capsule was 1.7 mm. The posterior popliteal ligament was easy to see in all the specimens, measuring around 42 mm in length. The Wrisberg meniscofemoral ligament was seen in 12 specimens. Conclusions: We can conclude that the distances from the center of the tibial insertion and the margin of the PCL to the joint capsule were 10.3 mm and 1.7 mm, respectively, thus enabling greater knowledge of the anatomy of the posterior compartment of the knee. Clinical Relevance: Our findings provide anatomic data that increase the safety and knowledge regarding the surgical procedures related to the PCL, because we have supplied information that can contribute to obtaining the best arthroscopic view of this area, thus decreasing the risk of vascular and nerve damage.
Macroscopic and histological evaluation of the posterior cruciate ligament in arthritic knees
Indian Journal of Orthopaedics Surgery, 2023
Background: The function of Posterior Cruciate Ligament (PCL) in Total Knee Arthroplasty is currently under debate. Supporters of PCL retention suggest better soft tissue balance as well as proprioception, whereas the adversaries have reported an unstable late flexion. Whether the PCL is retained or removed, the results of knee replacement remains the same. The aim of the present study was to look for the morphologic and histological changes in PCL, that aids in assessing its competence, and to compare these with macroscopic changes. Materials and Methods: A prospective study was performed on 50 osteoarthritic knees. Both the cruciate ligaments were examined macroscopically during Total Knee Replacement surgery, and classified as normal, fatty, mucinous, or cystic. The PCL was also studied and staged histopathologically, and was compared with its macroscopic appearance. Results: On macroscopic examination, fatty type degeneration was the most common type of degeneration in both PCL and ACL, seen in 68% and 56% cases respectively. Histopathologically, majority of the PCLs (52.4%) were in stage 1 of degeneration. 5 PCLs that appeared macroscopically normal showed degeneration microscopically and 8 PCLs that were histologically normal had fatty as well as mucinous degeneration on macroscopic examination. Conclusion: PCL exhibits degenerative and chronic traumatic modifications of different degrees on microscopic examination. These changes cannot be predicted from macroscopic inspection of the knee at the time of surgery. The frequency of these changes suggests that PCLs in an osteoarthritic knee are of varying quality, and this should be considered by the surgeon while selecting the type of knee replacement. Keywords: Osteoarthritis, Anterior cruciate ligament, Posterior cruciate ligament, Cartilage, Meniscus, Degeneration, Macroscopy.
Anterior cruciate ligament: an anatomical exploration in humans and in a selection of animal species
Knee Surgery, Sports Traumatology, Arthroscopy, 2013
Purpose Many anatomical anterior cruciate ligament (ACL) studies have indicated that the human ACL is composed of two functional bundles: the antero-medial (AM) and postero-lateral (PL). The purpose of this study is to compare the ACL anatomy among human and assorted animal species. Methods Twenty fresh-frozen knees specimen were used: five humans, ten porcine, one goat, one Kodiak bear, one African lion, one Diana monkey and one Gazelle antelope. All the specimens were dissected to expose the ACL and to visualize the number of bundles and attachment patterns on the tibia and femur. Following the fibre orientation of the individual bundles, a wire loop was used to bluntly separate the bundles starting from the tibial insertion site to the femoral insertion site. In the human and porcine ACL, each bundle was separated into approximately 2 mm diameter segments and then tracked in order to establish the individual bundle's specific pattern of insertion on the femur and tibia. Results It appeared that all human and animal knee specimens had three bundles that made up their ACL. In addition, it was noted that among the various specimens species, all viewed with an anterior view, and at 90°knee flexion, the ACL bony insertion sites had similar attachment patterns. Conclusion In all the specimens, including human, the ACL had three distinct bundles: AM, intermediate (IM) and PL. The bundles were composed of multiple fascicles arranged in a definite order and similar among the different species.