Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities

Norwood, Lyle A.; Cross, Mervyn J.

doi:10.1177/036354657900700106

Cited by 219 publications

(116 citation statements)

References 5 publications

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“…Contrary to authors such as Horwitz,15 who divided the cruciate ligaments into 2 bundles of fibers, but in agreement with Norwood & Cross, 16 the present study confirms the cruciate ligament as possessing 3 bundles of fibers that intertwine among themselves during leg flexion.…”

Section: Discussionsupporting

confidence: 88%

Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

Júnior

Caldana

et al. 2007

Clinics

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PURPOSE:The purpose of this study was to evaluate a low-cost and easily reproducible technique for biomechanical studies in cadavers. In this kind of study, the natural effect of loading of the joint and shear forces are not taken into account. The objective is to describe the plastic deformation of the ligaments into 3-dimensional space. METHOD: For 18 intact human cadaver knees, the cruciate ligaments were divided into 3 fiber bundles, the tibial or femoral fixation points were marked, and 2 perpendicular different x-ray exposures were performed, thus obtaining radiographs of spatial projections of the bundle in 3 anatomic planes (frontal, sagittal, and transversal). From the measurements made on the x-ray films, we obtained the average distance between the 2 fixation points of the cruciate ligaments on the tibia and the femur at 4 different flexion angles. RESULTS:The distance between the fixation points of the medial and lateral fiber bundles of the cruciate ligaments did not change significantly during movement. There were, however, significant variations (P < .05) in the distance between the fixation points of the posterior fiber bundles of the anterior cruciate ligament and the anterior fiber bundles of the posterior cruciate ligament. CONCLUSIONS: This technique was efficient for demonstrating the plastic deformability of the cruciate ligaments. The results proceeding from this type of study can assist in the planning of physical rehabilitation programs.

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Section: Discussionsupporting

confidence: 88%

Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

Júnior

Caldana

et al. 2007

Clinics

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“…The ligament consists of two distinct functional bundles that are characterized by their spatial relationships throughout knee flexion and their different roles in biomechanics and stability: the anteromedial (AM) and posterolateral (PL) bundles [1,13,14]. Some authors have described a third intermediate (IM) bundle [15,16].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Knee Joint Stability Following Anterior Cruciate Ligament Reconstruction Using the Ligament Advanced Reinforcement System

Krupa¹,

Królikowska

Reichert

2017

Polim. Med.

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The anterior cruciate ligament (ACL) of the knee joint plays a complex role in the stabilization of the knee joint, resisting anterior displacement and excessive rotation of the tibia relative to the femur [1]. Reconstruction of the ACL of the knee joint [2] followed by a postoperative physiotherapeutic procedure [3] is the standard ACL injury treatment for individuals wishing to return to high-level sports activities. There are numerous current treatment options for ACL reconstruction, and in choosing the technique, the surgeon's experience and numerous patient-specific factors, as well as cost and efficacy, are taken under consideration [4,5]. Broadly, the available graft options include autografts and allografts, as well as synthetic ligaments. The autograft choices consist of the patellar, hamstring (Fig. 1), and quadriceps tendons, while allografts include the quadriceps, patellar, Achilles, hamstring, anterior and posterior tibialis tendons, and the fascia lata AbstractBackground. One of the goals of the synthetic materials used in knee joint reconstruction of the anterior cruciate ligament (ACL) is to improve the strength and stability of the graft immediately after the reconstruction. One of the synthetic grafts is a non-absorbable synthetic ligament device made of terephthalic polyethylene polyester fibers, the Ligament Advanced Reinforcement System (LARS). Objectives. The aim of the study was to assess postoperative knee joint stability in patients who had undergone ACL reconstruction using the LARS graft. Material and Methods. The study group was comprised of 20 males who had undergone primary unilateral intraarticular ACL reconstruction using LARS. The patients were evaluated one day before the reconstruction and an average of six weeks postoperatively. Knee stability was evaluated manually using the Lachman test, anterior drawer test and pivot-shift test. Knee active range of motion (ROM) was measured. Results. Preoperatively, the Lachman test indicated abnormal/2+ results in the vast majority of the patients. The postoperative results in most of the patients were normal/0. The anterior drawer test results were also abnormal/2+ preoperatively and normal/0 postoperatively. The pivot-shift test was positive in all of the patients before the ACL reconstruction and negative after the surgery. In general, no differences were found in the ROM between the involved and uninvolved limbs and in the between-measurement comparison. Conclusions. The evaluation demonstrated significant progress from the preoperative to postoperative results in reducing anterior translation and anterolateral rotational instability of the tibia in patients who had undergone ACL reconstruction using the synthetic LARS graft. In the short-term follow-up assessments, restoration of anterior and anterolateral rotational stability of the operated knee joints was observed (Polim. Med. 2016, 46, 2, 155-161).

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“…[9][10][11] Some authors have distinguished a 3 rd bundle in the anatomy of the ACL, the intermediate (IM) bundle. 12,13 The ACL aims to resist anterior displacement and excessive rotation of the tibia relative to the femur.…”

Section: Anterior Cruciate Ligament (Acl) Of the Knee Jointmentioning

confidence: 99%

Synthetic grafts in the treatment of ruptured anterior cruciate ligament of the knee joint

et al. 2017

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Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities

Cited by 219 publications

References 5 publications

Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

Experimental Evaluation of 3-Dimensional Kinematic Behavior of the Cruciate Ligaments

Postoperative Knee Joint Stability Following Anterior Cruciate Ligament Reconstruction Using the Ligament Advanced Reinforcement System

Synthetic grafts in the treatment of ruptured anterior cruciate ligament of the knee joint

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