Variation in the shape of the tibial insertion site of the anterior cruciate ligament: classification is required

Guenther, Daniel; Irarrázaval, Sebastián; Nishizawa, Yuichiro; Vernacchia, Cara; Thorhauer, Eric; Musahl, Volker; Irrgang, James J.; Fu, Freddie H.

doi:10.1007/s00167-015-3891-2

Cited by 41 publications

(39 citation statements)

References 29 publications

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“…The comparison between our results and those of other authors, by the various modes of evaluation, is found in ►Table 3. [3][4][5][6][7][8][9][10][11][12][13][18][19][20][21][22][23][24] In fact, Lord et al 25 published a study of the function of the ACL tibial insertion fibers in the resistance of anterior and rotational displacements, with robotics, in six degrees of freedom of movement. They concluded that the central, posterior and lateral fibers of the ACL tibial insertion play a secondary role in the restriction of tibial displacements and that the most important fibers are the anterior and the anteromedial peripheral portion.…”

Section: Discussionmentioning

confidence: 99%

Correlação entre características antropométricas individuais e as medidas da fóvea tibial do ligamento cruzado anterior

et al. 2019

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Resumo Objetivo Avaliar possíveis relações entre o peso e altura de pacientes submetidos à artroplastia total do joelho com o comprimento, largura e área da fóvea do ligamento cruzado anterior, verificados na cirurgia. Métodos Um total de 33 superfícies articulares tibias proximais, obtidas nos cortes tibiais de artroplastia total do joelho de 33 pacientes, foram utilizadas no presente estudo. O ligamento cruzado anterior foi dissecado cuidadosamente e ressecado com bisturi delicado, para expor sua fóvea. Depois, a periferia dessa fóvea foi demarcada por pequenos pontos, com um marcador. Cada peça foi fotografada e as medições do comprimento, largura e área da fóvea tibial do ligamento cruzado anterior foram feitas com o programa ImageJ (National Institutes of Health, Bethesda, MD, EUA). A análise estatística avaliou a correlação entre os dados antropométricos dos pacientes com as medidas da fóvea tibial do ligamento cruzado anterior. Resultados O comprimento, a largura e a área médios da fóvea tibial do ligamento cruzado anterior foram, respectivamente 11,7 ± 2,0 mm, 7,1 ± 1,4 mm e 151,3 ± 22,2 mm2. Houve relação estatisticamente significativa entre a altura dos pacientes e a largura da fóvea tibial do ligamento cruzado anterior. A largura da fóvea do ligamento cruzado anterior pôde ser predita pela fórmula: largura = 107,294–(133,179 × altura) + (44,009 × altura ao quadrado). Conclusão A altura dos pacientes pôde a prever a largura da fóvea tibial do ligamento cruzado anterior e, assim, pode ajudar os cirurgiões escolher o enxerto mais adequado para cada paciente, nas reconstruções do ligamento cruzado anterior.

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Section: Discussionmentioning

confidence: 99%

Correlação entre características antropométricas individuais e as medidas da fóvea tibial do ligamento cruzado anterior

et al. 2019

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“…The tibial and femoral osseous attachments of the ACL have been widely studied, and despite traditionally having an oval and crescent-like shape respectively, potential variations in their shape have been suggested. 95,96 The anatomical characteristics of the attachments, in conjunction with the tendency to avoid impingement, led to interesting operative concepts, such as the meticulous placement of the ACL graft within the tibial and femoral footprints, i.e. complete footprint restoration.…”

Section: Ideal Position Characteristicsmentioning

confidence: 99%

Anterior cruciate ligament reconstruction: principles of treatment

2016

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Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in sports medicine. Several areas of controversy exist in ACL tear management which have engaged surgeons and researchers in debates towards identifying an ideal approach for these patients.This instructional review discusses the principles of ACL reconstruction in an attempt to provide guidelines and initiate a critical thinking approach on the most common areas of controversy regarding ACL reconstruction.Using high-level evidence from the literature, as presented in randomised controlled trials, systematic reviews, and meta-analyses, operative versus conservative treatment, timing of surgery, and rehabilitation are discussed. Also, the advantages and disadvantages of the most common types of autografts, such as patellar tendon and hamstrings as well as allografts are presented.Key considerations for the anatomical, histological, biomechanical and clinical data (‘IDEAL’) graft positioning are reviewed.Cite this article: Paschos NK, Howell SM. Anterior cruciate ligament reconstruction: principles of treatment. EFORT Open Rev 2016;398-408. DOI: 10.1302/2058-5241.1.160032.

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“…In a recent study of 100 patients, mean age 26 years, undergoing ACL reconstruction, the tibial insertion was elliptical in 51 knees, triangular in 33 knees, and C-shaped in 16 knees. 6 Posterolateral fatty degeneration was observed in 26 knees. Given the smaller number of C-shaped insertion sites in this younger age group, fatty degeneration with aging may explain the C-shaped appearance of some specimens.…”

Section: See Related Article On Page 2101mentioning

confidence: 99%

Editorial Commentary: Tibial Attachment of the Anterior Cruciate Ligament: Just 1 Piece to the Complex Puzzle of Individualized, Anatomic Anterior Cruciate Ligament Reconstruction

Meredith

Musahl

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The anterior cruciate ligament (ACL) is a complex, biologic structure that continues to be explored in the literature. Given the individual uniqueness of the ACL, variation exists, and studies continue to attempt to tease out what is truly important for ACL reconstruction. Although individual components of the ACL structure provide function, the ACL works as a dynamic structure, in unison with the surrounding bony morphology, to produce normal knee kinematics. Ultimately, in ACL reconstruction, the surgeon is tasked with restoring the native dimensions, collagen orientation, and insertion sites according to the individual anatomy.

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Variation in the shape of the tibial insertion site of the anterior cruciate ligament: classification is required

Abstract: III.

Cited by 41 publications

References 29 publications

Correlação entre características antropométricas individuais e as medidas da fóvea tibial do ligamento cruzado anterior

Correlação entre características antropométricas individuais e as medidas da fóvea tibial do ligamento cruzado anterior

Anterior cruciate ligament reconstruction: principles of treatment

Editorial Commentary: Tibial Attachment of the Anterior Cruciate Ligament: Just 1 Piece to the Complex Puzzle of Individualized, Anatomic Anterior Cruciate Ligament Reconstruction

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