Dataset Information

Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament.

ABSTRACT:

Background

Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint.

Purpose

To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue.

Study design

Descriptive laboratory study.

Methods

The tibial ACL footprint was dissected from 20 different fresh-frozen cadaveric knees (all males; mean age, 68.8 ± 5.4 years [range, 55-80 years]; mean weight, 78 ± 6.6 kg [range, 45-93 kg]). Two knees, 1 with severe osteoarthritis and 1 with previous knee surgery, were excluded. The tibial ACL insertion was observed, and this area was longitudinally divided into 4 parallel slices (0%-25%, 25-50%, 50%-75%, and 75%-100%), embedded in paraffin wax, and stained with hematoxylin-eosin, alcian blue, and picrosirius-polarization. The specimens were measured using a microscope to determine the distances from the anterior to the posterior border of the ACL ligament tibial insertion and the distance from the posterior border to the end of the ligament fibers of the ACL ligament tibial insertions.

Results

The 18 evaluated knee specimens confirmed the finding of a C-shaped tibial insertion of the ACL. The measurements showed that the ligament (vertical parallel collagen fibers) occupied only 30.8% of the complete insertion. The remaining area was filled with synovial tissue, demonstrating histologically the "C" shape.

Conclusion

This study confirms macroscopically the C-shaped tibial insertion of the ACL and shows histologically that synovial tissue is an indirect insertion filling the major part of the footprint.

Clinical relevance

This anatomic study suggests a different shape of the ACL tibial footprint, which may be useful for new perspectives regarding ACL reconstruction surgery research.

SUBMITTER: Janovsky C

PROVIDER: S-EPMC5103324 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Publications

Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament.

Janovsky César C Kaleka Camila Cohen CC Alves Maria Teresa Seixas MT Ferretti Mario M Cohen Moises M

Orthopaedic journal of sports medicine 20161108 11

<h4>Background</h4>Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint.<h4>Purpose</h4>To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue.<h4>Study design</h4>Descriptive laboratory study.<h4>Methods</h4>The ...[more]

PMID: 27868076

Similar Datasets

Project description:BackgroundWe aimed to evaluate clinical and radiological results after simultaneous open-wedge high tibial osteotomy (HTO) and anterior cruciate ligament (ACL) reconstruction in patients with ACL deficiency combined with medial uni-compartmental osteoarthritis (OA) and varus deformity.MethodsThis retrospective study was performed using data collected from 2005 to 2011 on a total of 24 patients who were diagnosed with ACL injury and medial unicompartmental OA with varus deformity, and who subsequently underwent simultaneous open-wedge HTO and arthroscopic ACL reconstruction. The mean follow-up duration was 5.2 years. For clinical outcomes, we evaluated Lysholm score, Tegner activity score, range of motion, Lachmann test, and pivot-shift test, and for radiological outcomes, we evaluated the degree of varus deformity, progression of medial OA, tibial posterior slope, anterior instability, and postoperative complication.ResultsThere were no limitations in range of motion found in any cases. Three patients showed progressive osteoarthritis on the medial compartment. The mechanical femorotibial angle was significantly corrected from varus 7.0 degrees to valgus 1.2 degrees, and the tibial posterior slope was not significantly changed. The Lysholm and Tegner activity scores were significantly improved after surgery (from 58 to 94 points on the Lysholm scale and from 4.0 to 5.3 points on the Tegner activity scale). Although the Lachman test and the pivot-shift test showed significant improvements after surgery, instability greater than Gr II was observed in three patients on the Lachman test and in four patients on the pivot-shift test. The side-to-side difference improved from 9.6 mm to 4.2 mm postoperatively as assessed using a Telos® arthrometer. There were no cases of nonunion or fixation loss.ConclusionsSimultaneous open-wedge HTO and ACL reconstruction in patients with ACL injury with medial compartmental OA showed satisfactory functional outcomes and postoperative activity level scores. However, some patients showed residual instability and progression of OA.

Dataset Information

Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament.

Background

Purpose

Study design

Methods

Results

Conclusion

Clinical relevance

Publications

Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament.

Similar Datasets

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