Anterior Cruciate Ligament (ACL): Difference between revisions

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The anterior cruciate ligament (ACL) is a band of dense connective tissue which courses from the femur to the tibia. The ACL is a key structure in the knee joint, as it resists anterior tibial translation and rotational loads.  
The anterior cruciate ligament (ACL) is a band of dense connective tissue which courses from the femur to the tibia. The ACL is a key structure in the knee joint, as it resists anterior tibial translation and rotational loads.  


== Origin  ==
== Attachments ==


Deep within the notch of the distal femur with the proximal fibers fanning out along the medial wall of the lateral femoral condyle.
=== Origin  ===


== Orientation ==
Arises from the posteromedial corner of medial aspect of lateral femoral condyle in the intercondylar notch. &nbsp;This&nbsp;femoral attachment of ACL is on posterior part of medial surface of lateral condyle well posterior to longitudinal axis of the <br> femoral shaft. &nbsp;The&nbsp;attachment is actually an interdigitation of collagen fibers &amp; rigid bone thru transitional zone of <br> fibrocartilage and mineralized fibrocartilage<ref>Wheeless, C,R. Wheeless' Textbook of Orthopaedics. [http://www.wheelessonline.com/ortho/anatomy_of_acl http://www.wheelessonline.com/ortho/anatomy_of_acl] Accessed 8/1/12.</ref>.<br>


=== Insertion  ===


Anterior to the intercondyloid eminence of the tibia, being blended with the anterior horn of the medial meniscus.&nbsp;&nbsp;The tibial attachment is in a fossa in front of &amp; lateral to anterior spine, a rather wide area from 11 mm in width to 17 mm in AP direction


== Insertion ==
== Nerve Supply ==


Anterior to the intercondyloid eminence of the tibia, being blended with the anterior horn of the medial meniscus.
The ACL is innervated by posterior articular branches of the tibial nerve.  


== Nerve Supply ==
== Vascular Supply ==


The ACL is innervated by posterior articular branches of the tibial nerve.
The ACL is vascularized by branches of the middle genicular artery.  
 
== Vascular Supply ==
 
The ACL is vascularized by branches of the middle genicular artery.


== Features  ==
== Features  ==

Revision as of 13:39, 8 January 2012

Introduction[edit | edit source]

The anterior cruciate ligament (ACL) is a band of dense connective tissue which courses from the femur to the tibia. The ACL is a key structure in the knee joint, as it resists anterior tibial translation and rotational loads.

Attachments[edit | edit source]

Origin[edit | edit source]

Arises from the posteromedial corner of medial aspect of lateral femoral condyle in the intercondylar notch.  This femoral attachment of ACL is on posterior part of medial surface of lateral condyle well posterior to longitudinal axis of the
femoral shaft.  The attachment is actually an interdigitation of collagen fibers & rigid bone thru transitional zone of
fibrocartilage and mineralized fibrocartilage[1].

Insertion[edit | edit source]

Anterior to the intercondyloid eminence of the tibia, being blended with the anterior horn of the medial meniscus.  The tibial attachment is in a fossa in front of & lateral to anterior spine, a rather wide area from 11 mm in width to 17 mm in AP direction

Nerve Supply[edit | edit source]

The ACL is innervated by posterior articular branches of the tibial nerve.

Vascular Supply[edit | edit source]

The ACL is vascularized by branches of the middle genicular artery.

Features[edit | edit source]

The ACL has a microstructure of collagen bundles of multiple types (mostly type I) and a matrix made of a network of proteins, glycoproteins, elastic systems, and glycosaminoglycans with multiple functional interactions[2]. There are two components of the ACL, the anteromedial bundle (AMB) and the posterolateral bundle (PLB), named according to where the bundles insert into the tibial plateau. They are not isometric with the main change being lengthening of the AMB and shortening of the PLB during flexion.

Function[edit | edit source]

Resists anterior translation and medial rotation of the tibia, in relation to the femur.

References[edit | edit source]

  1. Wheeless, C,R. Wheeless' Textbook of Orthopaedics. http://www.wheelessonline.com/ortho/anatomy_of_acl Accessed 8/1/12.
  2. Duthon VB, Barea C, Abrassart S, Fasel JH, Fritschy D, Ménétrey J. Anatomy of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2006 Mar;14(3):204-13. Epub 2005 Oct 19.