Relationship between thickness of the anteromedial bundle and thickness of the posterolateral bundle in the normal ACL

Abstract

The AMB is thicker than the PLB, showing a constant correlation in the normal ACL. This suggests that the anteromedial graft must be thicker than the posterolateral graft at least in actual operations.

Quantitative In Situ Analysis of the Anterior Cruciate Ligament

“…2,10,11,22,23,[25][26][27] The CSA values of the midsubstance found in the present study are comparable with those previously reported in the literature (Table 1). Several studies have attempted to measure the CSA of the ACL while keeping it attached to the femur and tibia, 10,11,16 but a clear standard in the definition of ''midsubstance'' has not been established across these studies, and there was no consensus on the flexion angle of the knee at the time of measurements. Most studies have measured the CSA of the isolated ACL after removal from its bony attachments, preventing the physiological orientation and tension of the ligament.…”

“…Understanding how the CSA of the ACL midsubstance naturally varies along the ligament axis in various loading configurations and how the size of the isthmus compares with the femoral and tibial insertion site sizes is important for creating anatomic grafts with dimensions and functions similar to those of the native ligament. 1,12,30 Anatomic studies have been conducted using various methods to evaluate the CSA of the ACL at its midsubstance 2,3,10,12,16,22 without reaching a consensus or standard for measurement. The geometry of soft tissue structures such as the ACL is largely dictated by loading and orientation.…”

Effects of different initial bundle tensioning strategies on the outcome of double-bundle ACL reconstruction: a cohort study

“…Thicker half of the tendon was used for the AM bundle and the thinner half for the PL bundle. Recent anatomic study of the normal knee joint supports the selection of the graft thickness [ 15 ]. The graft was fixed for the femoral site with EndoButton ® (Smith & Nephew, Andover, MA).…”

Theoretical Biomechanics

“…There is some variation in the description of separate parts of the ligament at the macroscopic level. The pattern with greatest acceptance shows two bundles, anteromedial and posterolateral (Furman et al, 1976;Harner et al, 1999;Inderster et al, 1993;Katouda et al, 2011;Steckel et al, 2007). Harner et al (1999) and Steckel et al (2007) described the anteromedial bundle as arising from the proximal part of the femoral attachment, with the posterolateral bundle arising from the distal portion.…”