OBJECTIVE: The purpose of this paper is to review the most recent publications on the ACL and its morphology in which its microscopic composition and macroscopic anatomy are addressed.
RESULTS: The ACL consists of typeI (90%) and typeIII (10%) collagen matrix. Its length ranges from 27 to 38mm and its width from 10 to 12mm. The ACL cross-section area measures an average of 44mm2, and its shape resembles that of an hourglass or a bow tie. ACL bundles have been defined as anteromedial, intermediate, and posterolateral. Femoral and tibial footprints were seen to present a high degree of variability in shape and size. Furthermore, the blood supply is given by the medial genicular artery and innervation by the tibial nerve branches. Additionally, the ACL functionally prevents anterior translation of the tibia and stabilizes against the internal rotation of the tibia and valgus angulation of the knee.
CONCLUSIONS: There is great variability in the anatomy of the ACL as well as its attachment sites. At the same time, the shape and size of its footprint has become a factor in determining individualized ACL reconstruction. The persistence of morphological variability in the aging of the ACL and important aspects of surgical planning and decision making with respect to anatomical risk factors suggest that further studies are called for.
目的:本文的目的是回顾有关ACL及其形态学的最新出版物,其中涉及其微观组成和宏观解剖学。
结果:ACL由I型(90%)和III型(10%)胶原基质组成。它的长度范围从27到38毫米,宽度从10到12毫米。ACL的横截面积平均为44mm2,其形状类似于沙漏或领结。ACL束已被定义为前内侧,中间,和后外侧。发现股骨和胫骨足迹在形状和大小上表现出高度的变异性。此外,血液供应由内侧膝部动脉提供,神经支配由胫神经分支提供。此外,ACL在功能上防止胫骨的前平移,并稳定胫骨的内旋和膝关节的外翻角度。
结论:ACL的解剖结构及其附着部位存在很大差异。同时,其足迹的形状和大小已成为决定个性化ACL重建的一个因素。ACL老化过程中形态变异性的持续存在以及有关解剖风险因素的手术计划和决策的重要方面表明,需要进一步的研究。