https://www.ijmhr.org/ijar.htm editor_anatomy@ijmhr.org
ISSN:       2321-4281 (E) 2321-8967 (P)

IJAR.2018.287

DOWNLOAD PDF
Table of Contents

Type of Article:  Original Research

Volume 6; Issue 3.2 (August 2018)

Page No.: 5581-5586

DOI: https://dx.doi.org/10.16965/ijar.2018.287

THE MORPHOMETRIC STUDY OF ANTERIOR CRUCIATE LIGAMENT: A CADAVERIC STUDY

Sakkarai Jayagandhi *1,  Virender Kumar Nim 2,  M. Mohan Kumar 3,  S. Senthil Kumar 4.

*1 Assistant Professor, Department of Anatomy, Pondicherry Institute of Medical Sciences, Pondicherry, India.

*2 Professor, Department of Anatomy, Pondicherry Institute of Medical Sciences, Pondicherry, India.

3 Professor, Department Orthopaedics, Sri Ramachandra Medical College & Research Institute (Deemed to be University)  Porur – Chennai, India.

4 Professor, Department Anatomy, Sri Ramachandra Medical College & Research institute (Deemed to be University) Porur – Chennai, India.

Address for Correspondence: Sakkarai Jayagandhi, Department of Anatomy, Pondicherry Institute of Medical Sciences, Pondicherry – 605014, India. Phone: +91 –9894257906 E-Mail: sjayagandhi@gamil.com

ABSTRACT:

Introduction: The anterior cruciate ligament is frequently injured ligament of the knee. It divides into anteromedial and posterolateral budles attached into tibia and femur. This study aimed to measure the length and width of two bundles of ACL separately to observe the morphormetrical difference.  Since single or double bundle ACL reconstructive surgical procedure are commonly used by orthopaedic surgeon, our study may help them in hamstring or tendon graft procedures.

Material and Methods: The Cadaveric study was conducted in the department of Anatomy at Pondicherry institute of Medical sciences, Pondicherry from December 2015 – May 2016. Randomly selected thirty cadaveric was included for the study and knees with ACL tear; macroscopic degenerative changes or any evidence of trauma was excluded from the study.  We kept the knee in the angle of 300, 600   and 900 flexed position and sides were identified and divided into thirteen right and seventeen left. Made an “I” incision on the knee and reflected the skin and ligamentum patellae, the anterior cruciate ligament were observed as anteromedial and posterolateral bundles. The position of angle knee was measured by goniometer and the length and width was measured by digital vernier caliper. The data was presented as frequencies and proportions, mean and standard deviations. Statistical significance (p value) was considered at 0.05 levels.

Results: The mean and standard deviation of anteromedial bundle of anterior cruciate ligament showed in 300 position of knee was 40.3±1.61 and on right side of AMB (n=13) 40.87±1.77 and was in left of AMB (n=17) side of knee 39.86±1, In 600 35.94±2.37 right 36.09±2.61 and left 35.82±2.24, and in 900 position 32.27±2.33 on the right side was 32.25±2.25 on the left 32.28±2.45. Likewise the posterolateral bundle result in 300 positions was 32.07±3.01 on the right side 32.33±3.43 and in left side showed 31.86±2.74, 600 positions of PLB 28.63±2.77 right side 29.23±2.77 and left side 28.18±2.76 and   900 26.07±2.53 right 26.56±2.03 and left side 25.69±2.86. There was a statistically significant increase in transverse diameter. We observed P value of transverse diameter of anteromedial bundle at tibial attchment (0.01) and (0.05) in anteroposterior diameter of posterolateral at tibial and in middle (0.04) showed a statistically significant increase in transverse diameter.

Conclusion: ACL tears are managed surgically by a double bundle or single bundle ACL reconstruction technique. Recently, the anatomic double bundle ACL reconstruction has been found to be better in restoring the intact knee function compared to the conventional single bundle surgery when done perfectly. So our study of morphometric measurements of ACL can help the surgeons during accurate tendon graft procedure of anterior cruciate ligament reconstructive surgeries.

KEY WORDS: Reconstruction, anteromedial bundle, posterolateral bundle, Double-bundle, ACL.

REFERENCES

  1. Standring S Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 40th New York:Elsvier; Churchill Livingstone. 2008:1401.
  2. Shen W, Jordan S, Fu F. Review article: anatomic double bundle anterior cruciate ligament reconstruction. J Orthop Surg. Hong Kong. 2007 Aug; 15(2):216–221.
  3. Cheatham SA, Johnson DL. Anatomic revision ACL reconstruction. Sports Med Arthrosc. 2010 Mar; 18(1):33–39.
  4. Schreiber VM, van Eck CF, Fu FH. Anatomic Double-bundle ACL Reconstruction. Sports Med Arthrosc. 2010 Mar; 18(1):27–32.
  5. Saxena A, Ray B, Rajagopal KV,  D’Souza AS,  Pyrtuh S.  Morphometry and magnetic resonance imaging of anterior cruciate ligament and measurement of secondary signs of anterior cruciate       ligament tear. Bratisl Lek   2012; 113(1):539–543.
  6. Paterson FW, Trickey EL. Anterior cruciate ligament reconstruction using part of the patellar tendon as a free graft. J Bone Joint Surg Br. 1986 May; 68(3):453–7.
  7. Anatomy of ACL revisited- link between form and function. Available from: http://emgprddmzvip24457.dmz.upmc.com/MediaRelations/factsheets/Documents/AatomyACLRevisited.pdf.
  8. H, Musahl.V,  Freddie H. Fu. The femoral insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: a radiographic evaluation Knee. Surg Sports Traumatol Arthrosc. 2010; 18:52–55.
  9. Odensten M, Gillquist J. Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. J Bone Joint Surg Am. 1985 Feb; 67(2): 257 – 262.
  10. Kulkamthom N, Arkasihayuth A, Charakorn K, Chaimut M, Reeboonlap N. The study of anterior cruciate ligament footprint in Thai population: a human cadaveric study. J Med Assoc Thai. 2012 Oct ; (95):167-72.
  11. Moghaddam AB,  Torkaman A. A Cadaver Study of the Structures and Positions of the Anterior Cruciate Ligament in Humans. Int J Prev Med. 2013 Apr; 4(Suppl 1): S85–S91.
  12. Stijak L, Radonjic V, Nikolic V, Blagojevic Z, Aksic M, Filipovic B. Correlation between the morphometric parameters of the anterior cruciate ligament and the intercondylar width: gender and age differences. Knee Surg Sports Traumatol Arthrosc. 2009;17:812-1.

Cite this article: Sakkarai Jayagandhi, Virender Kumar Nim, M. Mohan Kumar, S. Senthil Kumar. THE MORPHOMETRIC STUDY OF ANTERIOR CRUCIATE LIGAMENT: A CADAVERIC STUDY. Int J Anat Res 2018;6(3.2):5581-5586. DOI: 10.16965/ijar.2018.287