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The interrelationship between anterior cruciate ligament tibial footprint and anterolateral meniscal root insertions: Quantitative, morphological and positional analyses using three-dimensional computed tomography images

The Knee Aug 02, 2019

Tensho K, Iwaasa T, Koyama S, et al. - Thirty-three fixed human cadaveric knees were assessed by the researchers in order to evaluate quantitative, morphological and positional variations between the anterior cruciate ligament (ACL) tibial footprint and anterolateral meniscal root (ALMR) insertion and examine an intraoperative landmark to estimate their boundaries. The anterior fiber (AF) and posterior fiber (PF) of ALMR, the tibial center of ACL bundles (anteromedial (AM) and posterolateral (PL) bundles) and ACL were marked following resection of the components. No important variation between the AF of AM and ACL was found, but both were significantly shorter than the AF of PL. Similarly, no notable variation between the PF of ACL and PL was observed, which were significantly shorter than PF of AM. Morphology of the ACL tibial insertion was listed as triangular, 15 knees, oval, 18 knees, and none, C-shape. In the oval type vs triangular type, AF insertion was significantly closer to AM and ACL centers. The AF/PF insertion was located laterally to the ML center of the medial and lateral intercondylar tubercles, except in two cases. Therefore, the proximity of ACL tibial footprint and ALMR differed by their footprint morphology. Moreover, for ALMR injury prevention, the medial and lateral intercondylar tubercles were beneficial landmarks.
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