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ACL anatomy: Is there still something to learn?
R Morales-Avalos1, E M Torres-González2, J R Padilla-Medina2
1Physiology Department, Faculty of Medicine, Universidad Autónoma de Nuevo León (U.A.N.L), Monterrey, Mexico; Department of Orthopedic Surgery, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain.
Revista Espanola De Cirugia Ortopedica Y Traumatologia
|February 14, 2023
Summary
The anterior cruciate ligament (ACL) shows significant anatomical variability in size, shape, and attachment sites. Understanding this variability is crucial for effective ACL reconstruction surgery.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Anatomy
Background:
- Knee anatomy, including bony and soft tissue structures, is extensively studied.
- Recent literature reveals a broad range of research focusing on the anterior cruciate ligament (ACL).
Purpose of the Study:
- To review current publications on the anterior cruciate ligament (ACL).
- To address the morphology of the ACL, including its microscopic composition and macroscopic anatomy.
Main Methods:
- Literature review of recent publications on ACL anatomy and morphology.
Main Results:
- The ACL is composed of 90% type I and 10% type III collagen.
- ACL dimensions: length 27–38mm, width 10–12mm, cross-sectional area ~44mm², hourglass/bow tie shape.
- Variability noted in bundle definitions (anteromedial, intermediate, posterolateral) and femoral/tibial footprints; supplied by the medial genicular artery and innervated by tibial nerve branches.
- Functional roles include preventing anterior tibial translation and stabilizing against internal rotation and valgus angulation.
Conclusions:
- Significant anatomical variability exists in the ACL and its attachment sites.
- ACL footprint characteristics influence individualized reconstruction strategies.
- Morphological changes with aging and anatomical risk factors necessitate further research for surgical planning.
