Anatomical variations in the tibial insertion of the Anterior Cruciate Ligament: An MRI study

Although tibial end avulsions of the anterior cruciate ligament are relatively common in clinical practice, avulsions of the femoral end of this ligament are by comparison rare. We present the case of an 11-year-old boy with a bony avulsion injury, which was presumed to have arisen from the tibial insertion of the anterior cruciate ligament but turned out instead to be an osteochondral avulsion fracture of the femoral origin. This unexpected finding that was not detected during preoperative workup resulted in the first attempt at surgical fixation being aborted. The need for a second planned definitive fixation procedure emphasises the importance of combining a thorough history and examination in association with appropriate imaging in the patient workup. The patient’s definitive operative treatment and outcome are described. Although rare, surgeons (and emergency room doctors) treating such patients should include femoral end avulsion injuries of the anterior cruciate ligament in the differential diagnosis of a child presenting with an acute haemarthrosis of the knee. Furthermore, once diagnosed, early onward referral to an experienced knee surgeon is advocated.

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Smaller Anterior Cruciate Ligament Diameter Is a Predictor of Subjects Prone to Ligament Injuries: An Ultrasound Study

BioMed Research International ◽

10.1155/2015/845689 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Parag Suresh Mahajan ◽

Prem Chandra ◽

Vidya Chander Negi ◽

Abhilash Pullincherry Jayaram ◽

Sheik Akbar Hussein

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Insertion Site ◽

Acl Injury ◽

Maximum Diameter ◽

Tibial Insertion ◽

Intercondylar Eminence ◽

Ultrasound Study ◽

Gender And Age ◽

Anterior Cruciate

Purpose. To test if diameter of normal anterior cruciate ligament (ACL) can be measured by ultrasound (US), to see if there is a relationship between smaller ACL diameter and ACL injury, and to assess agreement between radiologists in measuring ACL diameter in cases and matched controls.Materials and Methods. In this ethics committee-approved study, maximum diameter of ACL near tibial insertion site was measured by static and dynamic US study in 25 normal contralateral knees of subjects who suffered noncontact ACL injury and in 25 matched control subjects.Results. ACL was visualized as a thick linear hypoechoic band inserted approximately 11 mm caudal to the tibial plateau and the intercondylar eminence. Maximum diameter of contralateral ACL near tibial insertion site among injured subjects was significantly smaller than in noninjured subjects (0.62 ± 0.07 cm versus 0.81 ± 0.06 cm;P<0.0001). In the regression analysis, the diameter of ACL near tibial insertion site was found significantly proportional to body weight and not significantly associated to height, gender, and age.Conclusion. Diameter of normal ACL near tibial insertion site can be measured by US and the maximum diameter is significantly smaller among subjects with noncontact ACL injury. US is a promising modality that can be used as an excellent screening test to detect subjects especially aspiring athletes prone to ACL injury. Very strong agreement was observed between radiologists in measuring ACL diameter.

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Do We have an Aimer to put the Tibial and Femoral Tunnels in the Same Line to reduce Mechanical Strain in Reconstructed Anterior Cruciate Ligament?

International Journal of Recent Surgical and Medical Sciences ◽

10.5005/jp-journals-10053-0059 ◽

2017 ◽

Vol 03 (02) ◽

pp. 130-131

Author(s):

Khalifa Elmajri

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Mechanical Strain ◽

Entry Point ◽

Acl Graft ◽

Tibial Insertion ◽

Graft Tension ◽

Postoperative Changes ◽

Graft Tissue ◽

Anterior Cruciate

AbstractThe strain between the ACL graft tissue and the osteochondral tissue at the tunnel entrances would lead to postoperative deviation of the femoral and/or tibial insertion of the ACL graft. Postoperative changes of the 3D orientation of the ACL graft affect its physiometry leading to failure of graft tension. A conception of an aimer is suggested to insure straightening of the intraosseous (tibial and femoral) and intra-articular parts of the graft at the tunnel entry point to overcome the postoperative angulation of intraosseous and intra-articular graft parts

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