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ICL: Anatomy of the ACL and Reconstruction

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ESSKA Instructional Course Lecture Book

Abstract

The ACL has two types of attachment margins. One is the relatively narrow oval attachment margin of the mid-substance (MS) fibres of ACL, and the other is the broader attachment margin of the “fan-like extension(FLE)” fibres, which extend from the MS fibres and broadly spread out on the posterior condyle.

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References

  1. Antonogiannakis E, Yiannakopoulos CK, Hiotis I, et al. Arthroscopic anterior cruciate ligament reconstruction using quadriceps tendon autograft and bioabsorbable cross-pin fixation. Arthroscopy. 2005;21:894.

    Article  PubMed  Google Scholar 

  2. Barie A, Huber J, Streich NA. Implant-free replacement of the anterior cruciate ligament – quadriceps tendon versus patellar tendon – long-term results of a prospective randomized clinical study. Knee Surg Sports Traumatol Arthrosc. 2012;20:34.

    Google Scholar 

  3. Chen CH, Chuang TY, Wang KC, et al. Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft: clinical outcome in 4–7 years. Knee Surg Sports Traumatol Arthrosc. 2006;14:1077–85.

    Article  CAS  PubMed  Google Scholar 

  4. De Angelis JP, Fulkerson JP. Quadriceps tendon – a reliable alternative for reconstruction of the anterior cruciate ligament. Clin Sports Med. 2007;26:587–96.

    Article  Google Scholar 

  5. Eriksson E. Patellar tendon or quadriceps tendon grafts for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2007;15:1283.

    Article  PubMed  Google Scholar 

  6. Fink C, Hoser C. Einzelbündeltechnik: Quadricepssehne in Portaltechnik. Arthroskopie. 2013;26:35–41.

    Article  Google Scholar 

  7. Garofalo R, Djahangiri A, Siegrist O. Revision anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft. Arthroscopy. 2006;22:205–14.

    Article  PubMed  Google Scholar 

  8. Geib TM, Shelton WR, Phelps RA, et al. Anterior cruciate ligament reconstruction using quadriceps tendon autograft: intermediate-term outcome. Arthroscopy. 2009;25:1408–14.

    Article  PubMed  Google Scholar 

  9. Gorschewsky O, Klakow A, Putz A, et al. Clinical comparison of the autologous quadriceps tendon (BQT) and the autologous patella tendon (BPTB) for the reconstruction of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2007;15:1284–92.

    Article  CAS  PubMed  Google Scholar 

  10. Hara K, et al. Anatomy of normal human anterior cruciate ligament attachments evaluated by divided small bundles. Am J Sports Med. 2009;37:2386.

    Google Scholar 

  11. Hoeher J, Balke M, Albers M, et al. Anterior cruciate ligament (ACL) reconstruction using a quadriceps tendon autograft and press-fit fixation has equivalent results compared to a standard technique using semitendinosus graft: a prospective matched-pair analysis after 1 year. Knee Surg Sports Traumatol Arthrosc. 2012;20:147.

    Article  Google Scholar 

  12. Kim SJ, Kumar P, Oh KS. Anterior cruciate ligament reconstruction: autogenous quadriceps tendon-bone compared with bone-patellar tendon-bone grafts at 2-year follow-up. Arthroscopy. 2009;25:137–44.

    Article  PubMed  Google Scholar 

  13. Lippe J, Armstrong A, Fulkerson JP. Anatomic guidelines for harvesting a quadriceps free tendon autograft for anterior cruciate ligament reconstruction. Arthroscopy. 2012;28:980–4.

    Article  PubMed  Google Scholar 

  14. Mochizuki T, Fujishiro H, Nimura A, Mahakkanukrauh P, Yasuda K, Muneta T, Akita K. Anatomic and histologic analysis of the mid-substance and fan-like extension fibres of the ACL during knee motion, with special reference to the femoral attachment. Knee Surg Sports Traumatol Arthrosc. 2014;22:336–44.

    Google Scholar 

  15. Mochizuki T, Muneta T, Nagase T, Shirasawa S, Akita KI, Sekiya I. Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. Arthroscopy. 2006;22(4):356–61.

    Article  PubMed  Google Scholar 

  16. Mohtadi NG, Chan DS, Dainty KN, et al. Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev. 2011;(9):CD005960.

    Google Scholar 

  17. Mulford JS, Hutchinson SE, Hang JR. Outcomes for primary anterior cruciate reconstruction with the quadriceps autograft: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2013;21:1882–8.

    Article  PubMed  Google Scholar 

  18. Samuelsson K, Andersson D, Karlsson J. Treatment of anterior cruciate ligament injuries with special reference to graft type and surgical technique: an assessment of randomized controlled trials. Arthroscopy. 2009;25:1139–74.

    Article  PubMed  Google Scholar 

  19. Sasaki N, Ishibashi Y, Tsuda E, Yamamoto Y, Maeda S, Mizukami H, Toh S, Yagihashi S, Tonosaki Y. The femoral insertion of the anterior cruciate ligament: discrepancy between macroscopic and histological observations. Arthroscopy. 2012;28(8):1135–46.

    Article  PubMed  Google Scholar 

  20. Shelton WR, Fagan BC. Autografts commonly used in anterior cruciate ligament reconstruction. J Am Acad Orthop Surg. 2011;19:259–64.

    PubMed  Google Scholar 

  21. Siebold R, Schuhmacher P. Restoration of the tibial ACL footprint area and geometry using the Modified Insertion Site Table. Knee Surg Sports Traumatol Arthrosc. 2012;20(9):1845–9.

    Article  PubMed  Google Scholar 

  22. Smigielski R, et al. Ribbon concept of the anterior cruciate ligament. KSSTA J. 2013 (accepted for publication).

    Google Scholar 

  23. Stäubli H, Schatzmann L, Brunner P, et al. Mechanical tensile properties of the quadriceps tendon and patellar ligament in young adults. Am J Sports Med. 1999;27:27–34.

    PubMed  Google Scholar 

  24. Xerogeanes JW, Mitchell PM, Karsev PA, et al. Anatomic and morphological evaluation of the quadriceps tendon using 3-dimensional magnetic resonance imaging reconstruction: applications for anterior cruciate ligament autograft choice and procurement. Am J Sports Med. 2013;41(10):2392–9.

    Article  PubMed  Google Scholar 

  25. Yasuda K, et al. Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy. 2004;20:1015.

    Google Scholar 

  26. Adachi N, Ochi M, Uchio Y et al. Reconstruction of the anterior cruciate ligament. Single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br. 2004;86:515–20.

    Google Scholar 

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Correspondence to Rainer Siebold MD, PhD , Kazunori Yasuda MD, PhD , Robert Śmigielski MD , Rainer Siebold MD, PhD , Christian Fink MD, PhD or Timo Järvelä MD, PhD .

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Fink, C., Järvelä, T., Siebold, R., Śmigielski, R., Yasuda, K. (2014). ICL: Anatomy of the ACL and Reconstruction. In: Zaffagnini, S., Becker, R., Kerkhoffs, G., Espregueira Mendes, J., van Dijk, C. (eds) ESSKA Instructional Course Lecture Book. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-53983-1_6

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  • DOI: https://doi.org/10.1007/978-3-642-53983-1_6

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-53982-4

  • Online ISBN: 978-3-642-53983-1

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