Changes in ACL length at different knee flexion angles: an in vivo biomechanical study
Abstract
Recently, there has been a tremendous impetus on anatomical reconstruction of the anterior cruciate ligament (ACL), and the double‐bundle reconstruction concept has been advocated by many authors. It is, therefore, important to understand how the lengths of the two bundles of the ACL vary during different knee flexion angles as this could influence the angle of graft fixation during surgery. The aim of this study is to determine the change in length of the ACL bundles during different knee flexion angles. Ten subjects with normal knees were evaluated. A high‐resolution computer tomography scan was performed, and 3D knee images were obtained. These images were then imported to customized software, and digital length measurement of four virtual bundles (anatomical single bundle, AM, PL and over the top) was evaluated from fixed points on the femur and tibia. Length‐versus‐flexion curves were drawn, and statistical analysis was performed to evaluate changes in length for each bundle at varying angles of knee flexion (0°, 45°, 90° and 135°). All virtual bundles achieved greatest lengths at full extension. There was a significant difference between the posterolateral bundle length when compared to the other bundles at full extension. There were no significant differences between the lengths of the anteromedial and the over the top single bundles at all angles of knee flexion. Three‐dimensional computer tomography can be used to assess the length changes of the virtual anterior cruciate ligament bundles, thereby allowing a better understanding of bundle function in clinical situations.
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The computed AMB and PLB lengths were within the ranges observed in vivo by Yoo et al. at knee-flexion angles of 45° and 90°.
“Both the AMB and PLB lengths were within the ranges observed thorugh in vivo measurements by Yoo et al. [9] at KFAs of 45 ◦ and 90 ◦ .”
From Computational study of kinematics of the anterior cruciate ligament double-bundle structure during passive knee flexion-extension (2020) · cites this paper as [9]
The computational model's findings are consistent with cadaver and in vivo experimental results.
“Both the AMB and PLB lengths were within the ranges observed thorugh in vivo measurements by Yoo et al. [9] at KFAs of 45 ◦ and 90 ◦ .”
From Computational study of kinematics of the anterior cruciate ligament double-bundle structure during passive knee flexion-extension (2020) · cites this paper as [9]
The AMB lengths with AP displacement of 5 and 0 mm were outside the range of in vivo measurements reported by Yoo et al. at a knee-flexion angle of 90°.
“As l AP decreased to 5 and 0 mm, the AMB was shortened, and the AP displacement decreased; these lengths were outside the range of the in vivo measurements reported by Yoo et al. [9] at a KFA of 90 ◦ .”
From Computational study of kinematics of the anterior cruciate ligament double-bundle structure during passive knee flexion-extension (2020) · cites this paper as [9]
Recent in vivo measurements showed that both ACL bundles are longest at full knee extension.
“Recent in vivo measurements showed that both bundles are longest at full 224 knee extension [7, 8, 9, 10].”
From Computational study of kinematics of the anterior cruciate ligament double-bundle structure during passive knee flexion-extension (2020) · cites this paper as [9]
Cites
Amis, A., & Dawkins, G. (1991) · The Journal of Bone and Joint Surgery. British volume · doi:10.1302/0301-620x.73b2.2005151 · Cited by 731 · see citing works
Li, G., DeFrate, L. E., Sun, H., & Gill, T. J. (2004) · The American Journal of Sports Medicine · doi:10.1177/0363546503262175 · Cited by 182 · see citing works
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Wang, J. H., Kato, Y., Ingham, S. J. M., Maeyama, A., Linde‐Rosen, M., Smolinski, P., & Fu, F. H. (2012) · Arthroscopy · doi:10.1016/j.arthro.2012.03.004 · Cited by 30 · see citing works
Self-citationOtani, T., Kobayashi, Y., & Tanaka, M. (2020) · Medical Engineering & Physics · doi:10.1016/j.medengphy.2020.07.015 · Cited by 7 · see citing works
- Authors
- Yoo, Y., Jeong, W., Shetty, N. S., Ingham, S. J. M., Smolinski, P., & Fu, F.
- Affiliations
- Hallym University (KR)
- University of Pittsburgh (US)
- Corresponding author
- Fu, Freddie
- Venue
- Knee Surgery, Sports Traumatology, Arthroscopy
- Publisher
- Wiley
- Published
- 2009-11-14
- Volume
- 18
- Issue
- 3
- Pages
- 292-297
- ISSN
- 0942-2056 (ISSN-L)
- 1433-7347
- OpenAlex
- W1985967780
- Cited by
- 63
- References
- 2
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 6 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 5 · 2015: 7 · 2014: 3 · 2013: 4 · 2012: 8
- FWCI
- 5.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Knee Surgery Sports Traumatology Arthroscopy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
- Keywords
- anterior cruciate ligament, knee flexion angle, double-bundle reconstruction, posterolateral bundle, anteromedial bundle, computed tomography
- MeSH terms
- Adult, Biomechanical Phenomena, Humans, Knee Joint, Male, Tomography, X-Ray Computed, Range of Motion, Articular, Anterior Cruciate Ligament, Imaging, Three-Dimensional, Young Adult
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