Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2012

01.01.2012 | Knee

The arrangement and the attachment areas of three ACL bundles

verfasst von: Hidenori Otsubo, Konsei Shino, Daisuke Suzuki, Tomoaki Kamiya, Tomoyuki Suzuki, Kota Watanabe, Mineko Fujimiya, Takehiko Iwahashi, Toshihiko Yamashita

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Normal anterior cruciate ligament (ACL) can be divided into three fiber bundles—i.e., anteromedial (AM), intermediate (IM), and posterolateral (PL) bundles. However, their arrangement and attachment areas had remained unclear. The purpose of this study was to clarify the arrangement of these three ACL fiber bundles and their attachment sites, and to provide information on the tunnel placement in anatomical triple bundle ACL reconstruction.

Methods

Seven non-embalmed human frozen knees were used. ACL fibers were bluntly divided into three bundles. A different-colored thread was wound around each fiber bundle in a spiral. Macroscopical investigation was performed to clarify the arrangement of three ACL bundles. Each fiber bundle was carefully detached from the femur and tibia, and then the distribution of attachment sites of each fiber bundle was observed.

Results

In knee extension, all bundles consisting of AM, IM and PL bundles ran parallel to each other in the lateral view from the medial side. The AM bundle overlapped with the IM bundle, whereas the PL bundle ran parallel to them on the distal aspects. As the knee flexion increased, the bundles became twisted around each other. On the tibial side, the attachment areas of three fiber bundles formed a triangular shape showing arrangements of AM, IM and PL bundles on the anteromedial, anterolateral and posterior aspects, respectively. On the femoral side, the PL bundle was attached on the distal-posterior areas; the IM bundle was attached distal-anterior to the AM bundle. They were arranged in a triangular shape on the tibia side as well.

Conclusion

This study clarified the arrangement of three fiber bundles of ACL and detailed geographical locations of their attachment sites. The detailed anatomic description of the natural ACL attachment might suggest to surgeons where to make tunnels during anatomical double/triple bundle ACL reconstruction.
Literatur
1.
Zurück zum Zitat Amis AA, Dawkins GP (1991) Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br 73:260–267PubMed Amis AA, Dawkins GP (1991) Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br 73:260–267PubMed
2.
Zurück zum Zitat Amis AA, Jakob RP (1998) Anterior cruciate ligament graft positioning, tensioning and twisting. Knee Surg Sports Traumatol Arthrosc 6(Suppl 1):S2–12PubMedCrossRef Amis AA, Jakob RP (1998) Anterior cruciate ligament graft positioning, tensioning and twisting. Knee Surg Sports Traumatol Arthrosc 6(Suppl 1):S2–12PubMedCrossRef
3.
Zurück zum Zitat Arnoczky SP (1983) Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res 172:19–25PubMed Arnoczky SP (1983) Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res 172:19–25PubMed
4.
Zurück zum Zitat Benjamin M, Ralphs JR (2001) Entheses—the bony attachments of tendons and ligaments. Ital J Anat Embryol 106:151–157PubMed Benjamin M, Ralphs JR (2001) Entheses—the bony attachments of tendons and ligaments. Ital J Anat Embryol 106:151–157PubMed
5.
Zurück zum Zitat Colombet P, Robinson J, Christel P (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22:984–992PubMedCrossRef Colombet P, Robinson J, Christel P (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22:984–992PubMedCrossRef
6.
Zurück zum Zitat Dargel J, Pohl P, Tzikaras P et al (2006) Morphometric side-toside differences in human cruciate ligament insertions. Surg Radiol Anat 28:398–402PubMedCrossRef Dargel J, Pohl P, Tzikaras P et al (2006) Morphometric side-toside differences in human cruciate ligament insertions. Surg Radiol Anat 28:398–402PubMedCrossRef
7.
Zurück zum Zitat Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225PubMedCrossRef
8.
Zurück zum Zitat Friederich NF, O’Brien WR (1992) Clinical application of biomechanic and functional anatomical findings of the knee joint. Orthopade 21:41–50PubMed Friederich NF, O’Brien WR (1992) Clinical application of biomechanic and functional anatomical findings of the knee joint. Orthopade 21:41–50PubMed
9.
Zurück zum Zitat Fujie H, Otsubo H, Shino K et al (2011) Mechanical functions of the three bundles consisting of the human anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc PMID:21541712 Fujie H, Otsubo H, Shino K et al (2011) Mechanical functions of the three bundles consisting of the human anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc PMID:21541712
10.
Zurück zum Zitat Georgoulis AD (2007) Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clini Orthop Relat Res 454:89–94CrossRef Georgoulis AD (2007) Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clini Orthop Relat Res 454:89–94CrossRef
11.
Zurück zum Zitat Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231PubMedCrossRef Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231PubMedCrossRef
12.
Zurück zum Zitat Giron F, Cuomo P, Edwards A, Bull AM, Amis AA, Aglietti P (2007) Double-bundle “anatomic” anterior cruciate ligament reconstruction: a cadaveric study of tunnel positioning with a transtibial technique. Arthroscopy 23:7–13PubMedCrossRef Giron F, Cuomo P, Edwards A, Bull AM, Amis AA, Aglietti P (2007) Double-bundle “anatomic” anterior cruciate ligament reconstruction: a cadaveric study of tunnel positioning with a transtibial technique. Arthroscopy 23:7–13PubMedCrossRef
13.
Zurück zum Zitat Harner CD, Baek GH, Vogrin TM et al (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15:741–749PubMedCrossRef Harner CD, Baek GH, Vogrin TM et al (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15:741–749PubMedCrossRef
14.
Zurück zum Zitat Hamada M, Shino K, Horibe S, Mitsuoka T, Miyama T, Shiozaki Y, Mae T (2001) Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with endobutton femoral fixation: a prospective study. Arthroscopy 17:801–807PubMed Hamada M, Shino K, Horibe S, Mitsuoka T, Miyama T, Shiozaki Y, Mae T (2001) Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with endobutton femoral fixation: a prospective study. Arthroscopy 17:801–807PubMed
15.
Zurück zum Zitat Hart AJ, Buscombe J, Malone A, Dowd GS (2005) Assessment of osteoarthritis after reconstruction of the anterior cruciate ligament: a study using single-photon emission computed tomography at ten years. J Bone Joint Surg Br 87:1483–1487PubMedCrossRef Hart AJ, Buscombe J, Malone A, Dowd GS (2005) Assessment of osteoarthritis after reconstruction of the anterior cruciate ligament: a study using single-photon emission computed tomography at ten years. J Bone Joint Surg Br 87:1483–1487PubMedCrossRef
16.
Zurück zum Zitat Hutchinson MR, Ash SA (2003) Resident’s ridge: assessing the cortical thickness of the lateral wall and roof of the intercondylar notch. Arthroscopy 19:931–935PubMedCrossRef Hutchinson MR, Ash SA (2003) Resident’s ridge: assessing the cortical thickness of the lateral wall and roof of the intercondylar notch. Arthroscopy 19:931–935PubMedCrossRef
17.
Zurück zum Zitat Iwahashi T, Shino K, Nakata K et al (2008) Assessment of the “functional length” of the three bundles of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 16:167–174PubMedCrossRef Iwahashi T, Shino K, Nakata K et al (2008) Assessment of the “functional length” of the three bundles of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 16:167–174PubMedCrossRef
18.
Zurück zum Zitat Iwahashi T, Shino K, Otsubo H et al (2010) Direct anterior cruciate ligament insertion to the femur assessed by histology and 3-dimensional volume-rendered computed tomography. Arthroscopy 26:S13–S20PubMedCrossRef Iwahashi T, Shino K, Otsubo H et al (2010) Direct anterior cruciate ligament insertion to the femur assessed by histology and 3-dimensional volume-rendered computed tomography. Arthroscopy 26:S13–S20PubMedCrossRef
19.
Zurück zum Zitat Kopf S, Musahl V, Tashman S, Szczodry M, Shen W, Fu FH (2008) A systematic review of the femoral origin and tibial insertion morphology of the ACL. Arthroscopy 17:213–219 Kopf S, Musahl V, Tashman S, Szczodry M, Shen W, Fu FH (2008) A systematic review of the femoral origin and tibial insertion morphology of the ACL. Arthroscopy 17:213–219
20.
Zurück zum Zitat Kondo E, Yasuda K, Azuma H, Tanabe Y, Yagi T (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36:1675–1687PubMedCrossRef Kondo E, Yasuda K, Azuma H, Tanabe Y, Yagi T (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36:1675–1687PubMedCrossRef
21.
Zurück zum Zitat Loh JC, Fukuda Y, Tsuda E, Steadman RJ, Fu FH, Woo SL (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: comparison between 11 o’clock and 10 o’clock femoral tunnel placement. Arthroscopy 19:297–304PubMedCrossRef Loh JC, Fukuda Y, Tsuda E, Steadman RJ, Fu FH, Woo SL (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: comparison between 11 o’clock and 10 o’clock femoral tunnel placement. Arthroscopy 19:297–304PubMedCrossRef
22.
Zurück zum Zitat Luites JW, Wymenga AB, Blankevoort L et al (2007) Description of the attachment geometry of the anteromedial and posterolateral bundles of the ACL from arthroscopic perspective for anatomical tunnel placement. Knee Surg Sports Traumatol Arthrosc 15:1422–1431PubMedCrossRef Luites JW, Wymenga AB, Blankevoort L et al (2007) Description of the attachment geometry of the anteromedial and posterolateral bundles of the ACL from arthroscopic perspective for anatomical tunnel placement. Knee Surg Sports Traumatol Arthrosc 15:1422–1431PubMedCrossRef
23.
Zurück zum Zitat Mae T, Shino K, Matsumoto N, Nakata K, Nakamura N, Iwahashi T (2006) Force sharing between two grafts in the anatomical two-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 14:505–509PubMedCrossRef Mae T, Shino K, Matsumoto N, Nakata K, Nakamura N, Iwahashi T (2006) Force sharing between two grafts in the anatomical two-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 14:505–509PubMedCrossRef
24.
Zurück zum Zitat Maeda A, Shino K, Horibe S, Nakata K, Buccafusca G (1996) Anterior cruciate ligament reconstruction with multistranded autogenous semitendinosus tendon. Am J Sports Med 24:504–509PubMedCrossRef Maeda A, Shino K, Horibe S, Nakata K, Buccafusca G (1996) Anterior cruciate ligament reconstruction with multistranded autogenous semitendinosus tendon. Am J Sports Med 24:504–509PubMedCrossRef
25.
Zurück zum Zitat Mochizuki T, Muneta T, Nagase T, Shirasawa S, Akita K, Sekiya I (2006) Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. Arthroscopy 22:356–361PubMedCrossRef Mochizuki T, Muneta T, Nagase T, Shirasawa S, Akita K, Sekiya I (2006) Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. Arthroscopy 22:356–361PubMedCrossRef
26.
Zurück zum Zitat Mommersteeg TJ, Kooloos JG, Roeling FQ et al (1995) The fibre bundle anatomy of human cruciate ligaments. J Anat 187:461–471PubMed Mommersteeg TJ, Kooloos JG, Roeling FQ et al (1995) The fibre bundle anatomy of human cruciate ligaments. J Anat 187:461–471PubMed
27.
Zurück zum Zitat Morimoto Y, Ferretti M, Ekdahl M, Smolinski P, Fu FH (2009) Tibiofemoral joint contact area and pressure after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 25:62–69PubMedCrossRef Morimoto Y, Ferretti M, Ekdahl M, Smolinski P, Fu FH (2009) Tibiofemoral joint contact area and pressure after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 25:62–69PubMedCrossRef
28.
Zurück zum Zitat Muneta T, Takakuda K, Yamamoto H (1997) Intercondylar notch width and its relation to the configuration and cross-sectional area of the anterior cruciate ligament. A cadaveric knee study. Am J Sports Med 25:69–72PubMedCrossRef Muneta T, Takakuda K, Yamamoto H (1997) Intercondylar notch width and its relation to the configuration and cross-sectional area of the anterior cruciate ligament. A cadaveric knee study. Am J Sports Med 25:69–72PubMedCrossRef
29.
Zurück zum Zitat Musahl V, Voos JE, O’Loughlin PF, Choi D, Stueber V, Kendoff D, Pearle AD (2010) Comparing stability of different single- and double-bundle anterior cruciate ligament reconstruction techniques: a cadaveric study using navigation. Arthroscopy 26:S41–S48PubMedCrossRef Musahl V, Voos JE, O’Loughlin PF, Choi D, Stueber V, Kendoff D, Pearle AD (2010) Comparing stability of different single- and double-bundle anterior cruciate ligament reconstruction techniques: a cadaveric study using navigation. Arthroscopy 26:S41–S48PubMedCrossRef
30.
Zurück zum Zitat Norwood LA, Cross MJ (1979) Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities. Am J Sports Med 7:23–26PubMedCrossRef Norwood LA, Cross MJ (1979) Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities. Am J Sports Med 7:23–26PubMedCrossRef
31.
Zurück zum Zitat Odensten M, Gillquist J (1985) Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am 67:257–262PubMed Odensten M, Gillquist J (1985) Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am 67:257–262PubMed
32.
Zurück zum Zitat Otsubo H, Shino K, Nakamura N, Nakata K, Nakagawa S, Koyanagi M (2007) Arthroscopic evaluation of ACL grafts reconstructed with the anatomical two-bundle technique using hamstring tendon autograft. Knee Surg Sports Traumatol Arthrosc 15:720–728PubMedCrossRef Otsubo H, Shino K, Nakamura N, Nakata K, Nakagawa S, Koyanagi M (2007) Arthroscopic evaluation of ACL grafts reconstructed with the anatomical two-bundle technique using hamstring tendon autograft. Knee Surg Sports Traumatol Arthrosc 15:720–728PubMedCrossRef
33.
Zurück zum Zitat Paschos NK, Gartzonikas D, Barkoula NM, Moraiti C, Paipetis A, Matikas TE, Georgoulis AD (2010) Cadaveric study of anterior cruciate ligament failure patterns under uniaxial tension along the ligament. Arthroscopy 26:957–967PubMedCrossRef Paschos NK, Gartzonikas D, Barkoula NM, Moraiti C, Paipetis A, Matikas TE, Georgoulis AD (2010) Cadaveric study of anterior cruciate ligament failure patterns under uniaxial tension along the ligament. Arthroscopy 26:957–967PubMedCrossRef
34.
Zurück zum Zitat Pietrini SD, Ziegler CG, Anderson CJ, Wijdicks CA, Westerhaus BD, Johansen S, Engebretsen L, Laprade RF (2011) Radiographic landmarks for tunnel positioning in double-bundle ACL reconstructions. Knee Surg Sports Traumatol Arthrosc 19:792–800PubMedCrossRef Pietrini SD, Ziegler CG, Anderson CJ, Wijdicks CA, Westerhaus BD, Johansen S, Engebretsen L, Laprade RF (2011) Radiographic landmarks for tunnel positioning in double-bundle ACL reconstructions. Knee Surg Sports Traumatol Arthrosc 19:792–800PubMedCrossRef
35.
Zurück zum Zitat Pombo MW, Shen W, Fu FH (2008) Anatomic double-bundle anterior cruciate ligament reconstruction: where are we today? Arthroscopy 24:1168–1177PubMedCrossRef Pombo MW, Shen W, Fu FH (2008) Anatomic double-bundle anterior cruciate ligament reconstruction: where are we today? Arthroscopy 24:1168–1177PubMedCrossRef
36.
Zurück zum Zitat Purnell ML, Larson AI, Clancy W (2008) Anterior cruciate ligament insertions on the tibia and femur and their relationships to critical bony landmarks using high-resolution volume-rendering computed tomography. Am J Sports Med 36:2083–2090PubMedCrossRef Purnell ML, Larson AI, Clancy W (2008) Anterior cruciate ligament insertions on the tibia and femur and their relationships to critical bony landmarks using high-resolution volume-rendering computed tomography. Am J Sports Med 36:2083–2090PubMedCrossRef
37.
Zurück zum Zitat Shino K, Nakata K, Otsubo H et al (2005) Anatomic anterior cruciate ligament reconstruction using two double-looped hamstring tendon grafts via twin femoral and triple tibial tunnels. Oper Tech Orthop Surg 15:130–134CrossRef Shino K, Nakata K, Otsubo H et al (2005) Anatomic anterior cruciate ligament reconstruction using two double-looped hamstring tendon grafts via twin femoral and triple tibial tunnels. Oper Tech Orthop Surg 15:130–134CrossRef
38.
Zurück zum Zitat Shino K, Nakata K, Nakamura N, Toritsuka Y, Nakagawa S, Horibe S (2005) Anatomically oriented anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft via rectangular socket and tunnel: a snug-fit and impingement-free grafting technique. Arthroscopy 21:1402PubMed Shino K, Nakata K, Nakamura N, Toritsuka Y, Nakagawa S, Horibe S (2005) Anatomically oriented anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft via rectangular socket and tunnel: a snug-fit and impingement-free grafting technique. Arthroscopy 21:1402PubMed
39.
Zurück zum Zitat Shino K, Nakata K, Nakamura N, Toritsuka Y, Horibe S, Nakagawa S, Suzuki T (2008) Rectangular tunnel double-bundle anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft to mimic natural fiber arrangement. Arthroscopy 24:1178–1183PubMedCrossRef Shino K, Nakata K, Nakamura N, Toritsuka Y, Horibe S, Nakagawa S, Suzuki T (2008) Rectangular tunnel double-bundle anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft to mimic natural fiber arrangement. Arthroscopy 24:1178–1183PubMedCrossRef
40.
Zurück zum Zitat Shino K, Suzuki T, Iwahashi T (2010) The resident’s ridge as an arthroscopic landmark for anatomical femoral tunnel drilling in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1164–1168PubMedCrossRef Shino K, Suzuki T, Iwahashi T (2010) The resident’s ridge as an arthroscopic landmark for anatomical femoral tunnel drilling in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 18:1164–1168PubMedCrossRef
41.
Zurück zum Zitat Siebold R, Ellert T, Metz S et al (2008) Femoral insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry and arthroscopic orientation models for double-bundle bone tunnel placement—a cadaver study. Arthroscopy 24:585–592PubMedCrossRef Siebold R, Ellert T, Metz S et al (2008) Femoral insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry and arthroscopic orientation models for double-bundle bone tunnel placement—a cadaver study. Arthroscopy 24:585–592PubMedCrossRef
42.
Zurück zum Zitat Siebold R, Ellert T, Metz S et al (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24:154–161PubMedCrossRef Siebold R, Ellert T, Metz S et al (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24:154–161PubMedCrossRef
43.
Zurück zum Zitat Takahashi M, Doi M, Abe M et al (2006) Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament. Am J Sports Med 34:787–792PubMedCrossRef Takahashi M, Doi M, Abe M et al (2006) Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament. Am J Sports Med 34:787–792PubMedCrossRef
44.
Zurück zum Zitat Toritsuka Y, Amano H, Kuwano M, Iwai T, Mae T, Ohzono K, Shino K (2009) Outcome of double-bundle ACL reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc 17:456–463PubMedCrossRef Toritsuka Y, Amano H, Kuwano M, Iwai T, Mae T, Ohzono K, Shino K (2009) Outcome of double-bundle ACL reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc 17:456–463PubMedCrossRef
45.
Zurück zum Zitat Tsukada H, Ishibashi Y, Tsuda E, Fukuda A, Toh S (2008) Anatomical analysis of the anterior cruciate ligament femoral and tibial footprints. J Orthop Sci 13:122–129PubMedCrossRef Tsukada H, Ishibashi Y, Tsuda E, Fukuda A, Toh S (2008) Anatomical analysis of the anterior cruciate ligament femoral and tibial footprints. J Orthop Sci 13:122–129PubMedCrossRef
46.
Zurück zum Zitat Yamakami Y et al (1998) The accuracy of square measure of regions of interest using an NIH image. J Showa Univ Dent Soc 18:400–405 Yamakami Y et al (1998) The accuracy of square measure of regions of interest using an NIH image. J Showa Univ Dent Soc 18:400–405
47.
Zurück zum Zitat Zantop T, Wellmann M, Fu FH, Petersen W (2008) Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstruction: anatomic and radiographic findings. Am J Sports Med 36:65–72PubMedCrossRef Zantop T, Wellmann M, Fu FH, Petersen W (2008) Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstruction: anatomic and radiographic findings. Am J Sports Med 36:65–72PubMedCrossRef
48.
Zurück zum Zitat Zhao J, Huangfu X (2010) Arbitrary starting point of separation affects morphology of the 2 bundles of anterior cruciate ligament at insertion sites. Arthroscopy 26:184–191PubMedCrossRef Zhao J, Huangfu X (2010) Arbitrary starting point of separation affects morphology of the 2 bundles of anterior cruciate ligament at insertion sites. Arthroscopy 26:184–191PubMedCrossRef
Metadaten
Titel
The arrangement and the attachment areas of three ACL bundles
verfasst von
Hidenori Otsubo
Konsei Shino
Daisuke Suzuki
Tomoaki Kamiya
Tomoyuki Suzuki
Kota Watanabe
Mineko Fujimiya
Takehiko Iwahashi
Toshihiko Yamashita
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1576-z

Weitere Artikel der Ausgabe 1/2012

Knee Surgery, Sports Traumatology, Arthroscopy 1/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.