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Cited by 29Knee injuries and reconstruction techniquesTendon Structure and TreatmentFoot and Ankle Surgery

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.

Torsional Appearance of the Anterior Cruciate Ligament Explaining “Ribbon” and Double‐Bundle Concepts: A Cadaver‐based Study

Noailles, Thibaut, Boisrenoult, Philippe, Sanchez, Matthieu, Beaufils, Philippe, Pujol, Nicolas·2017·Arthroscopy
DOI 10.1016/j.arthro.2017.03.019
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Abstract

Purpose: To investigate the effect of the anterior cruciate ligament (ACL) torsion in 90° knee flexion on the morphological appearance of the ACL. Methods: Sixty knees from fresh frozen anatomical specimens were dissected. Eighteen knees were excluded according to selection criteria (torn ACL, mucoid degeneration of the ACL, arthritic lesions of the notch, or knees harboring synovial inflammatory pathologies). After the removal of the synovial membrane, the morphology of the ligamentous fibers of the ACL and the twist were analyzed. Twisting of the ACL was measured using a goniometer in 90° knee flexion and defined by the angle of external rotation of the femur on the axis of the tibia required to visualize a flat ACL. The orientation of tibial and femoral footprint was described in a coronal plane for the tibia and a sagittal plane for the femur. Results: In the 42 knees that were finally included, the ACL was always displayed as a single ribbon‐like structure. The torsion of the fibers was on average 83.6° (± 9.4°) in 90° knee flexion. The twisting could be explained by the different orientations of the femoral (vertical in a sagittal plane) and tibial (horizontal in a coronal plane) footprints. An intraligamentous proximal cleavage area was encountered in 11 cases (i.e., 26%). Conclusions: The ACL is a twisted structure with 83.6° of external torsion of fibers in 90° knee flexion. It is the torsion in the fibers, due to the relative position of bone insertions, which gives the ACL the appearance of being double bundle. Clinical Relevance: The concept of the torsional flat structure of the native ACL may be of importance during ACL reconstruction, both in terms of graft choice (flat rather than cylindrical) and of technical positioning (torsion).

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Crossref · 10.1016/j.arthro.2017.03.019

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  • Noailles et al., using 60 cadaver knees, concluded that torsion in the ACL fibers due to the relative position of bone insertions makes the ACL appear to have a double-bundle structure.

    “Noailles et al. [44] studied the geometric characteristics of the 285 ACL using 60 cadaver knees and concluded that the torsion in the ACL fibers 286 because of the relative position of bone insertions makes the ACL appear to 287 have a double-bundle structure.”

    From Computational study of kinematics of the anterior cruciate ligament double-bundle structure during passive knee flexion-extension (2020) · cites this paper as [44]

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  1. 10.1007/978-3-642-45349-6_4 · DOI

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Metadata

Authors
Noailles, T., Boisrenoult, P., Sanchez, M., Beaufils, P., & Pujol, N.
Affiliations
Hôpital André Mignot (FR)
Corresponding author
Noailles, Thibaut
ORCID
Venue
Arthroscopy
Publisher
Wiley
Published
2017-09
Volume
33
Issue
9
Pages
1703-1709
ISSN
  • 0749-8063 (ISSN-L)
  • 1526-3231
DOI
10.1016/j.arthro.2017.03.019
OpenAlex
W2751576926
Cited by
29
References
36
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 1
FWCI
4.20
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Arthroscopy The Journal of Arthroscopic and Related Surgery (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, femoral footprint, tibial footprint, anterior cruciate ligament reconstruction, graft selection, graft placement
MeSH terms
Anterior Cruciate Ligament Injuries, Aged, Aged, 80 and over, Cadaver, Female, Femur, Humans, Knee Joint, Male, Middle Aged, Rotation, Tibia, Anterior Cruciate Ligament, Transplants, Anterior Cruciate Ligament Reconstruction

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