Recently, the configuration of the anterior cruciate ligament (ACL) from its direct femoral insertion to midsubstance was found to be flat. This might have an important impact for anatomical ACL reconstruction. The purpose of this anatomical study was to evaluate the macroscopic appearance of the ACL from femoral to midsubstance.MethodsThe ACL was dissected in 111 human fresh frozen cadaver knees from its femoral insertion to midsubstance, and the shape was described. The anatomical findings were documented on digital photographs and on video. Thirty knees were sent for computed tomography (CT), magnetic resonance imaging (MRI) and histology of the femoral ACL insertion.ResultsTwo millimetres from its direct femoral insertion, the ACL fibres formed a flat ribbon in all dissected knees without a clear separation between AM and PL bundles. The ribbon was in exact continuity of the posterior femoral cortex. The width of the ribbon was between 11.43 and 16.18 mm and the thickness of the ACL was only 2.54–3.38 mm. 3D CT, MRI and the histological examination confirmed above findings.ConclusionThis is a detailed anatomical study describing the ribbon-like structure of the ACL from its femoral insertion to midsubstance. A key point was to carefully remove the surface fibrous membrane of the ACL. A total of 2–3 mm from its bony femoral insertion, the ACL formed a flat ribbon without a clear separation between AM and PL bundles. The ribbon was in exact continuity of the posterior femoral cortex. The findings of a flat ligament may change the future approach to femoral ACL footprint and midsubstance ACL reconstruction and to graft selection.Electronic supplementary materialThe online version of this article (doi:10.1007/s00167-014-3146-7) contains supplementary material, which is available to authorized users.
This paper focuses on the anatomical attachment of the medial meniscus. Detailed anatomical dissections have been performed and illustrated. Five zones can be distinguished in regard to the meniscus attachments anatomy: zone 1 (of the anterior root), zone 2 (anteromedial zone), zone 3 (the medial zone), zone 4 (the posterior zone) and the zone 5 (of the posterior root). The understanding of the meniscal anatomy is especially crucial for meniscus repair but also for correct fixation of the anterior and posterior horn of the medial meniscus.
Although the cardiac coronary system in mice has been the studied in detail by many research laboratories, knowledge of the cardiac veins remains poor. This is because of the difficulty in marking the venous system with a technique that would allow visualization of these large vessels with thin walls. Here we present the visualization of the coronary venous system by perfusion of latex dye through the right caudal vein. Latex injected intravenously does not penetrate into the capillary system. Murine cardiac veins consist of several principal branches (with large diameters), the distal parts of which are located in the subepicardium. We have described the major branches of the left atrial veins, the vein of the left ventricle, the caudal veins, the vein of the right ventricle and the conal veins forming the conal venous circle or the prepulmonary conal venous arch running around the conus of the right ventricle. The venous system of the heart drains the blood to the coronary sinus (the left cranial caval vein) to the right atrium or to the right cranial caval vein. Systemic veins such as the left cranial caval, the right cranial caval and the caudal vein open to the right atrium. Knowledge of cardiac vein location may help to elucidate abnormal vein patterns in certain genetic malformations.
The study aimed to assess the effects of compression trigger point therapy on the stiffness of the trapezius muscle in professional basketball players (Part A), and the reliability of the MyotonPRO device in clinical evaluation of athletes (Part B). Twelve professional basketball players participated in Part A of the study (mean age: 19.8 ± 2.4 years, body height 197 ± 8.2 cm, body mass: 91.8 ± 11.8 kg), with unilateral neck or shoulder pain at the dominant side. Part B tested twelve right-handed male athletes (mean ± SD; age: 20.4 ± 1.2 years; body height: 178.6 ± 7.7 cm; body mass: 73.2 ± 12.6 kg). Stiffness measurements were obtained directly before and after a single session trigger point compression therapy. Measurements were performed bilaterally over 5 points covering the trapezius muscle. The effects were evaluated using a full-factorial repeated measure ANOVA and the Bonferroni post-hoc test for equal variance. A p-value < .05 was considered significant. The RM ANOVA revealed a significant decrease in muscle stiffness for the upper trapezius muscle. Specifically, muscle stiffness decreased from 243.7 ± 30.5 to 215.0 ± 48.5 N/m (11.8%), (p = .008) (Part A). The test-retest relative reliability of trapezius muscle stiffness was found to be high (ICC from 0.821 to 0.913 for measurement points). The average SEM was 23.59 N/m and the MDC 65.34 N/m, respectively (Part B). The present study showed that a single session of compression trigger point therapy can be used to significantly decrease the stiffness of the upper trapezius among professional basketball players.
Anterior cruciate ligament (ACL) reconstruction is commonly performed and has been for many years. Despite this, the technical details related to ACL anatomy, such as tunnel placement, are still a topic for debate. In this paper, we introduce the flat ribbon concept of the anatomy of the ACL, and its relevance to clinical practice. Cite this article: Bone Joint J 2016;98-B:1020-6.
We performed a series of 16 anatomical dissections on Caucasian cadaver material to determine the surgical anatomy of the medial femoral circumflex artery (MFCA) and its anastomoses. These confirmed that the femoral head receives its blood supply primarily from the MFCA via a group of posterior superior nutrient arteries and the posterior inferior nutrient artery. In terms of anastomoses that may also contribute to the blood supply, the anastomosis with the inferior gluteal artery, via the piriformis branch, is the most important. These dissections provide a base of knowledge for further radiological studies on the vascularity of the normal femoral head and its vascularity after dislocation of the hip.
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