Neural anatomy of the human anterior cruciate ligament.

Schütte, Michael; Dabezies, Eugene J; Zimny, Marilyn L.; Happel, Leo T.

doi:10.2106/00004623-198769020-00011

Cited by 423 publications

(225 citation statements)

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“…[14][15][16][17] Therefore it seems reasonable to assume that the remnant tissue could be preserved, especially the tibial side, as a source of reinnervation if impingement and cyclops lesions can be prevented. 1,4,5,18 However, during remnant preservation, using an anterior portal could interfere with restoration of the anatomic footprint because remnant tissue could be an obstacle to formation of an anatomic tunnel location.…”

Section: Discussionmentioning

confidence: 99%

Creation of an Anatomic Femoral Tunnel With Minimal Damage to the Remnant Bundle in Remnant-Preserving Anterior Cruciate Ligament Reconstruction Using an Outside-In Technique

Ahn

Lee

2014

Arthroscopy Techniques

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We established a method for creation of an anatomic femoral tunnel with minimal damage to the remnant bundle in remnant-preserving anterior cruciate ligament (ACL) reconstruction. The goals of this surgical technique were to preserve the remnant bundle as much as possible, especially at the femoral insertion, and to make the tunnel at the anatomic position. The critical points are that the posterior side of the femoral footprint of the ACL is observed through the posterolateral portal using a 70 arthroscope and a femoral tunnel is made by use of an outside-in technique with remnant preservation. This technique allows for easy viewing of the posterior side of the ACL and enables performance of an anatomic ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

Creation of an Anatomic Femoral Tunnel With Minimal Damage to the Remnant Bundle in Remnant-Preserving Anterior Cruciate Ligament Reconstruction Using an Outside-In Technique

Ahn

Lee

2014

Arthroscopy Techniques

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“…The knee ligament injury, which often involves more than one anatomic joint structure, is not limited to a mechanical problem, since most torn intra-and periarticular tissues also contain neuronal receptors and afferent fibers (Kennedy et al 1982, O'Connor 1984, Schultz et al 1984, Schutte et al 1987, Zimney 1988. Information on limb positions and movements consists of input from visual, vestibular, cutaneous, muscular, tendinous and joint receptors (Williams 1981, Johansson et al 1991, but the relative contributions from each type and location of receptors are not known (Petersen 1995).…”

Section: Function After Anterior Cruciate Ligament Injuriesmentioning

confidence: 99%

Function after anterior cruciate ligament injuries: Influence of visual control and proprioception

Fridén

Roberts

Movin

et al. 1998

Acta Orthopaedica Scandinavica

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“…[1][2][3][4] Many studies have shown the existence of several types of mechanoreceptor in human and animal ACLs. [5][6][7][8] Whether these mechanoreceptors and their associated functions are restored after reconstruction of the ACL is uncertain. 1,5 Our aim therefore was to determine whether regenerated nerve fibres and mechanoreceptors in the reconstructed ACL could respond to mechanical loads applied to the ligament and to test for afferent impulses and somatosensory evoked potentials (SEPs), which would indicate functional restoration of axons and mechanoreceptors.…”

mentioning

confidence: 99%

Induction of somatosensory evoked potentials by mechanical stimulation in reconstructed anterior cruciate ligaments

Ochi

Iwasa

Uchio

et al. 2002

The Journal of Bone and Joint Surgery. British volume

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W e have determined whether somatosensory evoked potentials (SEPs) were detectable after direct mechanical stimulation of normal, injured and reconstructed anterior cruciate ligaments (ACLs) during arthroscopy. We investigated the position sense of the knee before and after reconstruction, and correlated the SEP with instability.Reproducible SEPs were detected in all 19 normal ACLs and in 36 of 38 ACLs reconstructed during a period of 13 months. Of the 45 injured ACLs, reproducible SEPs were detected in 26. The mean difference in anterior displacement in the SEP-positive group of the injured ACL group was significantly lower than that in the SEP-negative group. In the reconstructed group, the postoperative position sense was significantly better than the preoperative position sense. Our results indicate not only that sensory reinnervation occurs in the reconstructed ACL, but also that the response to mechanical loads can be restored, and is strongly related to improvement in position sense. Very little information is available regarding the sensory role of the anterior cruciate ligament (ACL). Although the mechanical contribution of the ligament is well documented, recent information suggests that it may have an important sensory role in initiating protective reflexes to control surrounding muscle tone through the 1a-musclespindle to the afferent-nerve system. [1][2][3][4] Many studies have shown the existence of several types of mechanoreceptor in human and animal ACLs.5-8 Whether these mechanoreceptors and their associated functions are restored after reconstruction of the ACL is uncertain. 1,5 Our aim therefore was to determine whether regenerated nerve fibres and mechanoreceptors in the reconstructed ACL could respond to mechanical loads applied to the ligament and to test for afferent impulses and somatosensory evoked potentials (SEPs), which would indicate functional restoration of axons and mechanoreceptors. Patients and MethodsWe enrolled 110 patients (110 knees) with intact posterior cruciate ligaments (PCL), but with knee injuries, into the study. Their mean age was 31 years (9 to 66). All gave consent and the protocol was approved by the Ethical Board of our institution. In four knees, mechanical stimulation of the intact PCL produced no cortical SE, because of technical defects and these individuals were excluded leaving 106 knees (106 patients, 49 men and 57 women) for analysis.The patients were placed into one of three groups. Group I comprised 21 men and 24 women of mean age 29.8 years with an injury to their ACL, who had been diagnosed with anterior instability before arthroscopy. They underwent an arthroscopically-assisted reconstruction of the ligament. In this group the ACL had been ruptured, but remnants were observed bridging the femur and tibia. These attachment sites were not anatomical and the bridging tissue was flimsy. Knees in which the remnant of the ACL was attached to the PCL were excluded from group I, since the mechanical stimulation of the remnant through its attachment could ind...

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Neural anatomy of the human anterior cruciate ligament.

Cited by 423 publications

References 0 publications

Creation of an Anatomic Femoral Tunnel With Minimal Damage to the Remnant Bundle in Remnant-Preserving Anterior Cruciate Ligament Reconstruction Using an Outside-In Technique

Creation of an Anatomic Femoral Tunnel With Minimal Damage to the Remnant Bundle in Remnant-Preserving Anterior Cruciate Ligament Reconstruction Using an Outside-In Technique

Function after anterior cruciate ligament injuries: Influence of visual control and proprioception

Induction of somatosensory evoked potentials by mechanical stimulation in reconstructed anterior cruciate ligaments

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