Background: Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint. Purpose: To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue. Study Design: Descriptive laboratory study. Methods: The tibial ACL footprint was dissected from 20 different fresh-frozen cadaveric knees (all males; mean age, 68.8 ± 5.4 years [range, 55-80 years]; mean weight, 78 ± 6.6 kg [range, 45-93 kg]). Two knees, 1 with severe osteoarthritis and 1 with previous knee surgery, were excluded. The tibial ACL insertion was observed, and this area was longitudinally divided into 4 parallel slices (0%-25%, 25-50%, 50%-75%, and 75%-100%), embedded in paraffin wax, and stained with hematoxylin-eosin, alcian blue, and picrosirius-polarization. The specimens were measured using a microscope to determine the distances from the anterior to the posterior border of the ACL ligament tibial insertion and the distance from the posterior border to the end of the ligament fibers of the ACL ligament tibial insertions. Results: The 18 evaluated knee specimens confirmed the finding of a C-shaped tibial insertion of the ACL. The measurements showed that the ligament (vertical parallel collagen fibers) occupied only 30.8% of the complete insertion. The remaining area was filled with synovial tissue, demonstrating histologically the “C” shape. Conclusion: This study confirms macroscopically the C-shaped tibial insertion of the ACL and shows histologically that synovial tissue is an indirect insertion filling the major part of the footprint. Clinical Relevance: This anatomic study suggests a different shape of the ACL tibial footprint, which may be useful for new perspectives regarding ACL reconstruction surgery research.
展开▼
机译：背景：尽管已经进行了许多有关前交叉韧带（ACL）的结构和附件的解剖学研究，但这些研究尚未就ACL足迹达成共识。目的：调查关于胫骨前交叉韧带插入（形态）形态的现有争议，并从组织学上确认胫骨前交叉韧带的足迹未完全充满韧带组织。研究设计：描述性实验室研究。方法：从20个不同的新鲜冷冻尸体膝盖（全部男性;平均年龄68.8±5.4岁[范围：55-80岁];平均体重：78±6.6 kg [范围：45-93 kg]）中解剖胫骨ACL足迹]）。排除了两个膝盖，其中1个患有严重的骨关节炎，另外1个先前进行过膝关节手术。观察到胫骨ACL插入，并将该区域纵向分成4个平行切片（0％-25％，25-50％，50％-75％和75％-100％），包埋在石蜡中并染色与苏木精-曙红，阿尔辛蓝和picrosirius极化。使用显微镜测量标本，以确定从ACL韧带胫骨插入物的前边界到后边界的距离以及从ACL韧带胫骨插入物的后边界到韧带纤维的末端的距离。结果：18个评估的膝盖样本证实了ACL的C形胫骨插入物的发现。测量结果表明，韧带（垂直平行胶原纤维）仅占完整插入的30.8％。其余区域充满滑膜组织，组织学上呈“ C”形。结论：这项研究从宏观上证实了ACL的C形胫骨插入，并且在组织学上显示滑膜组织是一种间接的填充，占据了足印的主要部分。临床意义：这项解剖学研究表明ACL胫骨足印的形状不同，这可能对ACL重建手术研究的新观点很有用。
展开▼
