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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2014

01-05-2014 | Knee

Anterior cruciate ligament: an anatomical exploration in humans and in a selection of animal species

Authors: Gof Tantisricharoenkul, Monica Linde-Rosen, Paulo Araujo, Jingbin Zhou, Patrick Smolinski, Freddie H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2014

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Abstract

Purpose

Many anatomical anterior cruciate ligament (ACL) studies have indicated that the human ACL is composed of two functional bundles: the antero-medial (AM) and postero-lateral (PL). The purpose of this study is to compare the ACL anatomy among human and assorted animal species.

Methods

Twenty fresh-frozen knees specimen were used: five humans, ten porcine, one goat, one Kodiak bear, one African lion, one Diana monkey and one Gazelle antelope. All the specimens were dissected to expose the ACL and to visualize the number of bundles and attachment patterns on the tibia and femur. Following the fibre orientation of the individual bundles, a wire loop was used to bluntly separate the bundles starting from the tibial insertion site to the femoral insertion site. In the human and porcine ACL, each bundle was separated into approximately 2 mm diameter segments and then tracked in order to establish the individual bundle’s specific pattern of insertion on the femur and tibia.

Results

It appeared that all human and animal knee specimens had three bundles that made up their ACL. In addition, it was noted that among the various specimens species, all viewed with an anterior view, and at 90° knee flexion, the ACL bony insertion sites had similar attachment patterns.

Conclusion

In all the specimens, including human, the ACL had three distinct bundles: AM, intermediate (IM) and PL. The bundles were composed of multiple fascicles arranged in a definite order and similar among the different species.
Literature
1.
go back to reference Amis AA (2012) The functions of the fibre bundles of the anterior cruciate ligament in anterior drawer, rotational laxity and the pivot shift. Knee Surg Sports Traumatol Arthrosc 20:613–620PubMedCrossRef Amis AA (2012) The functions of the fibre bundles of the anterior cruciate ligament in anterior drawer, rotational laxity and the pivot shift. Knee Surg Sports Traumatol Arthrosc 20:613–620PubMedCrossRef
2.
go back to reference Amis AA, Bull AMJ, Lie DTT (2005) Biomechanics of rotational instability and anatomic anterior cruciate ligament reconstruction. Oper Tech Ortho 15:29–35CrossRef Amis AA, Bull AMJ, Lie DTT (2005) Biomechanics of rotational instability and anatomic anterior cruciate ligament reconstruction. Oper Tech Ortho 15:29–35CrossRef
3.
go back to reference Amis AA, Dawkins GP (1991) Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Surg Br 73B:260–267 Amis AA, Dawkins GP (1991) Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Surg Br 73B:260–267
4.
go back to reference Amis AA, Jakob RP (1998) Anterior cruciate ligament graft positioning, tensioning and twisting. Knee Surg Sports Traumatol Arthrosc 6(Suppl 1):S2–12PubMedCrossRef Amis AA, Jakob RP (1998) Anterior cruciate ligament graft positioning, tensioning and twisting. Knee Surg Sports Traumatol Arthrosc 6(Suppl 1):S2–12PubMedCrossRef
5.
go back to reference Arnoczky SP (1983) Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res 172:19–25PubMed Arnoczky SP (1983) Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res 172:19–25PubMed
6.
go back to reference Colombet P, Robinson J, Christel P, Franceschi JP, Djian P, Bellier G, Sbihi A (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22:984–992PubMedCrossRef Colombet P, Robinson J, Christel P, Franceschi JP, Djian P, Bellier G, Sbihi A (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22:984–992PubMedCrossRef
7.
go back to reference Dienst M, Burks RT, Greis PE (2002) Anatomy and biomechanics of the anterior cruciate ligament. Orthop Clin North Am 33:605–620PubMedCrossRef Dienst M, Burks RT, Greis PE (2002) Anatomy and biomechanics of the anterior cruciate ligament. Orthop Clin North Am 33:605–620PubMedCrossRef
8.
go back to reference Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef
9.
go back to reference Ferretti M, Levicoff EA, Macpherson TA, Moreland MS, Cohen M, Fu FH (2007) The fetal anterior cruciate ligament: an anatomic and histologic study. Arthroscopy 23:278–283PubMedCrossRef Ferretti M, Levicoff EA, Macpherson TA, Moreland MS, Cohen M, Fu FH (2007) The fetal anterior cruciate ligament: an anatomic and histologic study. Arthroscopy 23:278–283PubMedCrossRef
10.
go back to reference Fujie H, Otsubo H, Fukano S, Suzuki T, Suzuki D, Mae T, Shino K (2011) Mechanical functions of the three bundles consisting of the human anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 19(Suppl 1):S47–S53PubMedCrossRef Fujie H, Otsubo H, Fukano S, Suzuki T, Suzuki D, Mae T, Shino K (2011) Mechanical functions of the three bundles consisting of the human anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 19(Suppl 1):S47–S53PubMedCrossRef
11.
go back to reference Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231PubMedCrossRef Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231PubMedCrossRef
12.
go back to reference Hara K, Mochizuki T, Sekiya I, Yamaguchi K, Akita K, Muneta T (2009) Anatomy of normal human anterior cruciate ligament attachments evaluated by divided small bundles. Am J Sports Med 37:2386–2391PubMedCrossRef Hara K, Mochizuki T, Sekiya I, Yamaguchi K, Akita K, Muneta T (2009) Anatomy of normal human anterior cruciate ligament attachments evaluated by divided small bundles. Am J Sports Med 37:2386–2391PubMedCrossRef
13.
go back to reference Harner CD, Baek GH, Vogrin TM, Carlin GJ, Kashiwaguchi S, Woo SL (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15:741–749PubMedCrossRef Harner CD, Baek GH, Vogrin TM, Carlin GJ, Kashiwaguchi S, Woo SL (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15:741–749PubMedCrossRef
14.
go back to reference Iwahashi T, Shino K, Nakata K, Nakamura N, Yamada Y, Yoshikawa H, Sugamoto K (2008) Assessment of the “functional length” of the three bundles of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 16:167–174PubMedCrossRef Iwahashi T, Shino K, Nakata K, Nakamura N, Yamada Y, Yoshikawa H, Sugamoto K (2008) Assessment of the “functional length” of the three bundles of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 16:167–174PubMedCrossRef
15.
go back to reference Kato Y, Ingham SJ, Linde-Rosen M, Smolinski P, Horaguchi T, Fu FH (2010) Biomechanics of the porcine triple bundle anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 18:20–25PubMedCrossRef Kato Y, Ingham SJ, Linde-Rosen M, Smolinski P, Horaguchi T, Fu FH (2010) Biomechanics of the porcine triple bundle anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 18:20–25PubMedCrossRef
16.
go back to reference Kennedy JC, Weinberg HW, Wilson AS (1974) The anatomy and function of the anterior cruciate ligament. As determined by clinical and morphological studies. J Bone Joint Surg Am 56:223–235PubMed Kennedy JC, Weinberg HW, Wilson AS (1974) The anatomy and function of the anterior cruciate ligament. As determined by clinical and morphological studies. J Bone Joint Surg Am 56:223–235PubMed
17.
go back to reference Kopf S, Musahl V, Tashman S, Szczodry M, Shen W, Fu FH (2009) A systematic review of the femoral origin and tibial insertion morphology of the ACL. Knee Surg Sports Traumatol Arthrosc 17:213–219PubMedCrossRef Kopf S, Musahl V, Tashman S, Szczodry M, Shen W, Fu FH (2009) A systematic review of the femoral origin and tibial insertion morphology of the ACL. Knee Surg Sports Traumatol Arthrosc 17:213–219PubMedCrossRef
18.
go back to reference Miyasaka KCDD, Shore ML, Hirsham P (1991) The incidence of knee ligament injuries in the general population. Am J Knee Surg 4:3–8 Miyasaka KCDD, Shore ML, Hirsham P (1991) The incidence of knee ligament injuries in the general population. Am J Knee Surg 4:3–8
19.
go back to reference Mochizuki T, Muneta T, Nagase T, Shirasawa S, Akita KI, Sekiya I (2006) Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. Arthroscopy 22:356–361PubMedCrossRef Mochizuki T, Muneta T, Nagase T, Shirasawa S, Akita KI, Sekiya I (2006) Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. Arthroscopy 22:356–361PubMedCrossRef
20.
go back to reference Mommersteeg TJ, Kooloos JG, Blankevoort L, Kauer JM, Huiskes R, Roeling FQ (1995) The fibre bundle anatomy of human cruciate ligaments. J Anat 187(Pt 2):461–471PubMedCentralPubMed Mommersteeg TJ, Kooloos JG, Blankevoort L, Kauer JM, Huiskes R, Roeling FQ (1995) The fibre bundle anatomy of human cruciate ligaments. J Anat 187(Pt 2):461–471PubMedCentralPubMed
21.
go back to reference Norwood LA, Cross MJ (1979) Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities. Am J Sports Med 7:23–26PubMedCrossRef Norwood LA, Cross MJ (1979) Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities. Am J Sports Med 7:23–26PubMedCrossRef
22.
go back to reference Odensten M, Gillquist J (1985) Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am 67:257–262PubMed Odensten M, Gillquist J (1985) Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am 67:257–262PubMed
23.
go back to reference Otsubo H, Shino K, Suzuki D, Kamiya T, Suzuki T, Watanabe K, Fujimiya M, Iwahashi T, Yamashita T (2012) The arrangement and the attachment areas of three ACL bundles. Knee Surg Sports Traumatol Arthrosc 20:127–134PubMedCrossRef Otsubo H, Shino K, Suzuki D, Kamiya T, Suzuki T, Watanabe K, Fujimiya M, Iwahashi T, Yamashita T (2012) The arrangement and the attachment areas of three ACL bundles. Knee Surg Sports Traumatol Arthrosc 20:127–134PubMedCrossRef
24.
go back to reference Petersen W, Tillmann B (2002) Anatomy and function of the anterior cruciate ligament. Orthopade 31:710–718PubMedCrossRef Petersen W, Tillmann B (2002) Anatomy and function of the anterior cruciate ligament. Orthopade 31:710–718PubMedCrossRef
25.
go back to reference Petersen W, Zantop T (2007) Anatomy of the anterior cruciate ligament with regard to its two bundles. Clin Ortho Relat Res 454:35–47CrossRef Petersen W, Zantop T (2007) Anatomy of the anterior cruciate ligament with regard to its two bundles. Clin Ortho Relat Res 454:35–47CrossRef
26.
27.
go back to reference Schindler OS (2012) Surgery for anterior cruciate ligament deficiency: a historical perspective. Knee Surg Sports Traumatol Arthrosc 20:5–47PubMedCrossRef Schindler OS (2012) Surgery for anterior cruciate ligament deficiency: a historical perspective. Knee Surg Sports Traumatol Arthrosc 20:5–47PubMedCrossRef
28.
go back to reference Siebold R, Ellert T, Metz S, Metz J (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24:154–161PubMedCrossRef Siebold R, Ellert T, Metz S, Metz J (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24:154–161PubMedCrossRef
29.
go back to reference Tallay A, Lim MH, Bartlett J (2008) Anatomical study of the human anterior cruciate ligament stump’s tibial insertion footprint. Knee Surg Sports Traumatol Arthrosc 16:741–746PubMedCrossRef Tallay A, Lim MH, Bartlett J (2008) Anatomical study of the human anterior cruciate ligament stump’s tibial insertion footprint. Knee Surg Sports Traumatol Arthrosc 16:741–746PubMedCrossRef
30.
go back to reference Tena-Arregui J, Barrio-Asensio C, Viejo-Tirado F, Puerta-Fonolla J, Murillo-Gonzalez J (2003) Arthroscopic study of the knee joint in fetuses. Arthroscopy 19:862–868PubMedCrossRef Tena-Arregui J, Barrio-Asensio C, Viejo-Tirado F, Puerta-Fonolla J, Murillo-Gonzalez J (2003) Arthroscopic study of the knee joint in fetuses. Arthroscopy 19:862–868PubMedCrossRef
31.
go back to reference Tischer T, Ronga M, Tsai A, Ingham SJ, Ekdahl M, Smolinski P, Fu FH (2009) Biomechanics of the goat three bundle anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 17:935–940PubMedCrossRef Tischer T, Ronga M, Tsai A, Ingham SJ, Ekdahl M, Smolinski P, Fu FH (2009) Biomechanics of the goat three bundle anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 17:935–940PubMedCrossRef
32.
go back to reference Walsh MP, Wijdicks CA, Parker JB, Hapa O, LaPrade RF (2009) A comparison between a retrograde interference screw, suture button, and combined fixation on the tibial side in an all-inside anterior cruciate ligament reconstruction: a biomechanical study in a porcine model. Am J Sports Med 37:160–167PubMedCrossRef Walsh MP, Wijdicks CA, Parker JB, Hapa O, LaPrade RF (2009) A comparison between a retrograde interference screw, suture button, and combined fixation on the tibial side in an all-inside anterior cruciate ligament reconstruction: a biomechanical study in a porcine model. Am J Sports Med 37:160–167PubMedCrossRef
33.
go back to reference Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed
34.
go back to reference Yasuda K, Kondo E, Ichiyama H, Tanabe Y, Tohyama H (2005) Surgical and biomechanical concepts of anatomic anterior cruciate ligament reconstruction. Oper Tech Orthop 15:96–102CrossRef Yasuda K, Kondo E, Ichiyama H, Tanabe Y, Tohyama H (2005) Surgical and biomechanical concepts of anatomic anterior cruciate ligament reconstruction. Oper Tech Orthop 15:96–102CrossRef
35.
go back to reference Zantop T, Petersen W, Fu FH (2005) Anatomy of the anterior cruciate ligament. Oper Tech Orthop 15:20–28CrossRef Zantop T, Petersen W, Fu FH (2005) Anatomy of the anterior cruciate ligament. Oper Tech Orthop 15:20–28CrossRef
36.
go back to reference Zantop T, Petersen W, Sekiya JK, Musahl V, Fu FH (2006) Anterior cruciate ligament anatomy and function relating to anatomical reconstruction. Knee Surg Sports Traumatol Arthrosc 14:982–992PubMedCrossRef Zantop T, Petersen W, Sekiya JK, Musahl V, Fu FH (2006) Anterior cruciate ligament anatomy and function relating to anatomical reconstruction. Knee Surg Sports Traumatol Arthrosc 14:982–992PubMedCrossRef
Metadata
Title
Anterior cruciate ligament: an anatomical exploration in humans and in a selection of animal species
Authors
Gof Tantisricharoenkul
Monica Linde-Rosen
Paulo Araujo
Jingbin Zhou
Patrick Smolinski
Freddie H. Fu
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2463-6

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