Flat anatomy of ACL and “ribbon like” ACL reconstruction

Abstract

Recent anatomical studies show clear evidence that the anterior cruciate ligament (ACL) has a ribbon like structure from its femoral origin to its tibial attachment. The femoral bony origin of the ACL is half-moon like and the tibial attachment is duck-foot like. On the femoral side the flat midsubstance raise from its origin in a straight line and on the tibial side in a "C"-shaped way. Twisting of the flat ACL from extension to flexion gives the impression of separate bundles. However, no bundles could be found in recent studies. Based on above findings this article introduce a new technique for a flat ACL reconstruction. It was developed to reproduce the native "ribbon like" morphology of the ACL, with a rectangular femoral-and a C-shaped tibial socket.