Optimal replacement of the cruciate ligaments from the functional-anatomical point of view

By means of a combined technique of dissection and radiography, the function of cruciate ligament fibers was analyzed for motions in the sagittal plane, and different functional fiber bundles were reconstructed in cadaver knees. In order to grant permanent stability, crucial replacement must be concentrated on the reconstruction of the constantly taut 'guiding bundle' of each cruciate ligament. The femoral attachment point of each guiding bundle was found to be in a constant position within the femoral attachment of the respective cruciate ligament. The femoral attachment areas of different functional fibers are also defined geometrically, and the consequences of improper guiding bundle replacement are discussed.