Injury of the anterior cruciate ligament (ACL) remains the most common cause leading to limited knee function and earlier development of gonarthrosis. The results of ACL repair in male and female patients remain heterogeneous. Women have worse results of surgical treatment, as well as higher risks of ACL injuries (from 1,5 to 10 times) when playing sports. It is assumed that the features of the anatomical structure of the knee play the key role in this joint. We have studied 40 unpaired anatomical preparations of the human knee joint obtained from women and men.The morphometry of the distal femoral epiphysis was performed using a digital sliding caliper according to 16 parameters. When examining the areas of femoral ACL attachment, their shape, size, area, and center distance from individual bone structures were assessed. The data obtained were correlated with the type of structure of the knee joint. Were studied the anatomical features characteristic of the "female" type of structure of the knee joint. It was found that the type of structure of the knee joint affects the topography of the femoral attachment area of the ACL, which must be taken into account in anatomical ligament reconstruction.

Complete traumatic injuries of the anterior cruciate ligament (ACL) are the most common knee injury among physically active males and females who are fond of both traditional and extreme sports. Surgical restoration of the anatomical structures of the injured joint, even with isolated ACL damage, remains an urgent problem of modern traumatology and orthopedics. The technology of arthroscopic reconstruction of the ACL is developing along the path of improving the technique of surgery, fixators, plastic materials. The article is devoted to the study of the results of arthroscopic anatomical plastic surgery of the anterior cruciate ligament with autografts from the patellar ligament with two bone blocks and the hamstring flexor tendons. The study included 100 patients of the main group and the comparison group with chronic damage to the anterior cruciate ligament and chronic anterior instability of the knee joint, which were divided into two groups depending on the type of transplant used. Long-standing injuries of the anterior cruciate ligament were diagnosed based on the results of a clinical examination, radiography, magnetic resonance imaging, and hardware arthrometry. Excellent and good results of surgical treatment were obtained in most patients of both groups, however, the highest stabilization indicators of the knee joint were noted in the comparison group.

Injuries to the anterior cruciate ligament of the knee joint, while remaining one of its most common types of injury, cause restriction of physical activity in people leading an active lifestyle, due to the occurrence of biomechanical disorder s. The generally accepted approach of surgical correction is aimed at replacing the lost structure in order to approach the motor norm of the preserved elements of the joint. The presented publication reflects the results of arthroscopic surgical reconstruction of the anterior cruciate ligament with an autograft from the patellar ligament by anatomical and transtibial methods. The main methods of diagnosing tears of the anterior cruciate ligament were clinical and instrumental studies, including manual testing, radiography, magnetic resonance imaging, hardware arthrometry. A total of 134 patients with long-standing damage to the anterior cruciate ligament and chronic anterior instability of the knee joint were treated, which were divided into two groups according to the method of plastic surgery. Complete recovery of the level of physical activity and return to sports were observed in the majority of patients of both clinical groups.

Background. The modern principles of reconstruction of the anterior cruciate ligament (ACL) and well-known surgical techniques do not take into account the peculiarities of the anatomical structure of the female knee. This happens due to insufficient substantiation that these peculiarities could influence the results of the treatment. The purpose of this study was to obtain new data on the structure of the areas of the ACL attachment, taking into consideration patient’s gender and the surgical anatomy. Material and Methods. 40 unpaired “fresh” anatomical preparations of the human female and male knees were studied. After preparation of the knee joints, the morphometry of the distal femoral epiphysis and the proximal tibial epiphysis was carried out by a digital sliding caliper according to 16 parameters. The shape, size, area, and the distance of the ACL attachment center from individual bone structures were assessed. The obtained data were correlated with the gender type of the knee structure. Results. The distal femoral epiphysis of the “female” type knee joint compared with the “male” type revealed the significant differences (p0.05) in the following parameters: the width of the condyles at the level of the transepicondylar line, the width of the intercondylar fossa, the length and height of the lateral condyle, and the ratio of the condyles width at the level of the transepicondylar line to the height of the lateral condyle. The tibial proximal epiphysis showed the gender differences in the articular surface frontal and sagittal dimensions, the width of the intercondylar eminence and the posterior slope of the tibial epiphysis articular surface. These features determined the different proportions of the female knee structure. The area of the anterior cruciate ligament femoral attachment and its center in the “female” type of structure were located 3 mm distal and 1.5 mm posteriorly (anteriorly and downwardly in arthroscopic imaging). The area of the tibial attachment of the same ligament and its center were localized 2 mm anteriorly in comparison with the “male” type structure. Conclusion. The discovered anatomical differences made it possible to distinguish the “female” and “male” types of the knee structure. The topography of the anterior cruciate ligament attachment areas is gender specific. This should be taken into account in the anatomical reconstruction of the ligament.