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, 53 (6), 727-731

Measurement of the Whole and Midsubstance Femoral Insertion of the Anterior Cruciate Ligament: The Comparison With the Elliptically Calculated Femoral Anterior Cruciate Ligament Footprint Area

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Measurement of the Whole and Midsubstance Femoral Insertion of the Anterior Cruciate Ligament: The Comparison With the Elliptically Calculated Femoral Anterior Cruciate Ligament Footprint Area

Genki Iwama et al. Indian J Orthop.

Abstract

Purpose: The purpose of this study was to measure the detailed morphology of the femoral anterior cruciate ligament (ACL) footprint. The correlation and the comparison between the measured area and the area which mathematically calculated as elliptical were also evaluated.

Materials and methods: Thirty nine nonpaired human cadaver knees were used. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch. The ACL was carefully dissected, and the periphery of the ACL insertion site was outlined on both the whole footprint and the midsubstance insertion. Lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The area, length, and width of the femoral ACL footprint were measured with Image J software (National Institution of Health). Using the length and width of the femoral ACL footprint, the elliptical area was calculated as 0.25 π (length × width). Statistical analysis was performed to reveal the correlation and the comparison of the measured and elliptically calculated area.

Results: The sizes of the whole and midsubstance femoral ACL footprints were 127.6 ± 41.7 mm2 and 61 ± 20.2 mm2, respectively. The sizes of the elliptically calculated whole and midsubstance femoral ACL footprints were 113.9 ± 4.5 mm2 and 58.4 ± 3 mm2, respectively. Significant difference was observed between the measured and the elliptically calculated area. In the midsubstance insertion, significant correlation was observed between the measured and the elliptically calculated area (Pearson's correlation coefficient = 0.603, P = 0.001). However, no correlation was observed in the whole ACL insertion area.

Conclusion: The morphology of the femoral ACL insertion resembles an elliptical shape. However, due to the wide variation in morphology, the femoral ACL insertion cannot be considered mathematically elliptical.

Keywords: Anatomy; anterior cruciate ligament; elliptical; femoral.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Measured and elliptically calculated femoral ACL insertion. (a) After marking an outline of the ACL footprint, each footprint was photographed with a digital camera. The pictures were downloaded to a personal computer and the area of the midsubstance insertion and the whole ACL insertion were measured using Image J software (National Institute of Health). (b) Using the length and width of the femoral ACL insertion, the elliptical area was calculated as: 0.25 π (length × width). ACL = Anterior cruciate ligament
Figure 2
Figure 2
Comparison of the measured and elliptically calculated femoral ACL insertion. Significant difference was observed between the measured and the elliptically calculated area both in the midsubstance and the whole femoral ACL insertions. ACL = Anterior cruciate ligament
Figure 3
Figure 3
Correlation analysis of the measured and elliptically calculated femoral midsubstance ACL insertion. Significant correlation was observed between the measured and the elliptically calculated midsubstance femoral ACL insertion. However, no correlation was observed in the whole ACL insertion. ACL = Anterior cruciate ligament

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