The arrangement and the attachment areas of three ACL bundles

Otsubo, Hidenori; Shino, Konsei; Suzuki, Daisuke; Kamiya, Tomoaki; Suzuki, Toshiya; Watanabe, Kota; Fujimiya, Mineko; Iwahashi, Takehiko; Yamashita, Toshihiko

doi:10.1007/s00167-011-1576-z

Cited by 68 publications

(54 citation statements)

References 46 publications

(141 reference statements)

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“…In 22 knees with the exception of the 2 knees depicted in two fiber bundles, the fiber arrangement of each bundle (Fig. 4) was same with that of the previous cadaveric report (Otsubo et al, 2012; Fig. 1).…”

Section: Resultssupporting

confidence: 78%

“…MacKay et al (2014) first reported the triple-bundle depiction, but the triple bundles were identifiable in only 15 out of 73 knees (20.5%) on MRI. However, in the previous studies using the fresh-frozen cadaveric knees, the triple-bundle ACL was macroscopically identifiable in all cases (Fujie et al, 2011;Kato et al, 2012;Otsubo et al, 2012;Suzuki et al, 2015).…”

Section: Introductionmentioning

confidence: 77%

“…On the femoral side, the AM-M bundle occupied superior-posterior portion of the proximal half of the whole attachment area, and the AM-L bundle attached its inferioranterior portion, while the PL bundle inserted distal half of the attachment area ( Fig. 1b; Otsubo et al, 2012). Also, the same research group found that the three bundles share the complementary functions mechanically (Fujie et al, 2011) and each bundle presents the different arrangement when observing with an electron microscope (Suzuki et al, 2015).…”

Section: Introductionmentioning

confidence: 83%

“…As a result, the fiber bundles were most clearly depicted in the oblique axial plane to the ACL in the slightly tibial side from the midpoint between the tibial attachment site and the femur attachment site of the ACL in all cases. Otsubo et al (2012) has described that the AM bundle was most clearly separated into the AM-M and AM-L bundles in the tibial side of the ligament when grossly identified in the cadaver knees. Our findings were also consistent with their report.…”

Section: Discussionmentioning

confidence: 99%

“…However, Norwood and Cross (1979) first reported that the ACL was composed of three fiber bundles. Otsubo et al (2012) reported a detailed study on the anatomical attachment sites and the *Correspondence to: Hidenori Otsubo, Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine S1-W16 Chuou-ku Sapporo, Japan 060-8543. E-mail: hide.…”

Section: Introductionmentioning

confidence: 99%

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MRI depiction and 3D visualization of three anterior cruciate ligament bundles

et al. 2016

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The anterior cruciate ligament (ACL) is divided into three fiber bundles (AM-M: anteromedial-medial, AM-L: anteromedial-lateral, PL: posterolateral). We attempted to depict the three bundles of the human ACL on MRI images and to obtain 3-dimensional visualization of them. Twenty-four knees of healthy volunteers (14 males, 10 females) were scanned by 3T-MRI using the fat suppression 3D coherent oscillatory state acquisition for the manipulation of imaging contrast (FS 3D-COSMIC). The scanned images were reconstructed after the isotropic voxel data, which allows the images to be reconstructed in any plane, was acquired. We conducted statistical examination on the identification rate of the three ACL bundles by 2D planes. Segmentation and 3D visualization of the fiber bundles using volume rendering were performed. The triple-bundle ACL was best depicted in the oblique axial plane. While the AM-M and AM-L bundles were clearly depicted in all cases, the PL bundle was not clearly visualized in two knees (8%). Therefore, the three ACL bundles were depicted in 22 knees (92%). The results of 3D visualization of the fiber arrangement agreed well with macroscopic findings of previous anatomical studies. 3T-MRI and the isotropic voxel data from FS 3D-COSMIC made it possible to demonstrate the identifiable depiction of three ACL bundles in nearly all cases. 3D visualization of the bundles could be a useful tool to understand the ACL fiber arrangement. Clin.

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Section: Resultssupporting

confidence: 78%

Section: Introductionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MRI depiction and 3D visualization of three anterior cruciate ligament bundles

et al. 2016

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Radiological evidence for the triple bundle anterior cruciate ligament

2014

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The anterior cruciate ligament (ACL) has traditionally been described as having two bundles--one anteromedial and one posterolateral. This has been challenged by studies proposing the existence of a third, intermediate, bundle with distinct functional significance, an arrangement that has been described in a number of domesticated animal species. No radiological evidence for the triple bundle ACL has previously been described. A prevalence study was carried out on 73 consecutive human knee magnetic resonance (MR) studies to determine the number of visible bundles, excluding individuals with a history of ACL injury or mucoid degeneration. A triple bundle ACL was demonstrated in 15 out of 73 human knees (20.5%, 95% confidence interval 12.9-31.2%). This is the first radiological description of the human triple bundle ACL. There was MR imaging evidence of a triple bundle ACL in approximately one fifth of human knees in this study.

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Ultrastructure of the three anterior cruciate ligament bundles

et al. 2015

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The anterior cruciate ligament (ACL) can be morphologically separated into not only two, but three bundles: the anteromedial-medial bundle (AM-MB), the anteromedial-lateral bundle (AM-LB), and the posterolateral bundle (PLB). Our hypothesis was that the three bundles differ in their microstructures. The purpose of this study was to clarify the microstructural differences among the three bundles. The normal ACLs of six fresh frozen cadavers were harvested. After the AM-MB, AM-LB, and PLB were identified, their fibril structures were analyzed using a transmission electron microscope. The fibril orientation, distribution pattern, and the mass average diameter of the fibrils (MAD) were compared among the AM-MBs, AM-LBs, and PLBs. The AM-MB and AM-LB fibrils were arranged mostly in the longitudinal direction, while the PLB fibrils were not aligned in a uniform direction. The fibril diameter distribution pattern of AM-MBs showed a bi-modal pattern due to the existence of small-diameter (30-40 nm) and large-diameter fibrils (70-80 nm), while that of the AM-LBs and PLBs had a unimodal pattern with one prominent high peak at a diameter of 50-60 nm. The mean MAD of the AM-MBs (83.2 - 11.2 nm) was significantly larger than that of the PLBs (66.8 - 7.7 nm), while it showed no significant difference compared to that of the AM-LBs (77.6 - 12.3 nm). The three ACL bundles have different ultrastructures. The AM-MB predominantly includes thick, uni-directionally oriented fibrils like tendons, while the PLB consists of thinner, multi-directionally oriented fibrils. The AM-LB shows an intermediate structure between the AM-MB and the PLB.

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The arrangement and the attachment areas of three ACL bundles

Cited by 68 publications

References 46 publications

MRI depiction and 3D visualization of three anterior cruciate ligament bundles

MRI depiction and 3D visualization of three anterior cruciate ligament bundles

Radiological evidence for the triple bundle anterior cruciate ligament

Ultrastructure of the three anterior cruciate ligament bundles

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