Three dimensional anatomy of the anterior cruciate ligament: a new approach in anatomical orthopedic studies and a literature review

Gustavo Gonçalves Arliani, Diego Costa Astur, Eduardo Ramalho Moraes, Camila Cohen Kaleka, Wahi Jalikjian, Pau Golano, Moisés Cohen, Gustavo Gonçalves Arliani, Diego Costa Astur, Eduardo Ramalho Moraes, Camila Cohen Kaleka, Wahi Jalikjian, Pau Golano, Moisés Cohen

Abstract

Background: The anterior cruciate ligament (ACL) is an important structure in the knee. The ACL does not heal following lesions, and surgical reconstruction is the standard treatment among athletes. Some steps of ACL reconstruction remain controversial. It is important to fully understand the anatomy of the ACL to accurately reproduce its anatomy during surgical reconstructions. The purpose of this study was to evaluate the use of anaglyphic images that produce 3D images to better visualize the anatomy of the ACL, and to highlight the anatomical features of this ligament as reported in the literature.

Methods: We included ten knees in this study. After dissection of the knee structures, pictures were acquired using a camera with Nikon D40, AF-S Nikkor 18-55 mm (1:3.5-5.6 G2 ED), and Micro Nikkor 105 mm (1:2.8) lenses. The pair of images was processed using Callipyan 3D Anabuilder software, which transforms the two images into one anaglyphic image.

Results: During the dissection of the knees, nine pictures were acquired and transformed into anaglyphic images.

Conclusion: This study, demonstrated that the use of 3D images is a useful tool that can improve the knowledge of the anatomy of the knee, while also facilitating knee reconstruction surgery.

Keywords: anaglyphic; anatomy education; education; eyeglasses; medical methods; photography methods.

Figures

Figure 1
Figure 1
Infrapatellar fat and the ligamentum mucosum.
Figure 2
Figure 2
PCL (1) and ACL (2) in knee flexion. Abbreviations: PCL, posterior cruciate ligament; ACL, anterior cruciate ligament.
Figure 3
Figure 3
ACL (2) and PCL (1) in the knee flexion. Abbreviations: PCL, posterior cruciate ligament; ACL, anterior cruciate ligament.
Figure 4
Figure 4
ACL (1) in the flexed knee: anterior view. Abbreviation: ACL, anterior cruciate ligament.
Figure 5
Figure 5
Femoral insertion of the ACL (1): posterior view. Abbreviation: ACL, anterior cruciate ligament.
Figure 6
Figure 6
ACL (1) without the medial condyle in the flexed knee: lateral view. Abbreviation: ACL, anterior cruciate ligament.
Figure 7
Figure 7
ACL (1) without the medial condyle in the extended knee: lateral view. Abbreviation: ACL, anterior cruciate ligament.
Figure 8
Figure 8
ACL anteromedial (1) and posterolateral (2) bundles without the medial condyle: lateral view. Abbreviation: ACL, anterior cruciate ligament.
Figure 9
Figure 9
ACL footprint (1) without the medial condyle. Abbreviation: ACL, anterior cruciate ligament.

References

    1. Matsumoto H, Suda Y, Otani T, Niki Y, Seedhom BB, Fujikawa K. Roles of the anterior cruciate ligament and the medial collateral ligament in preventing valgus instability. J Orthop Sci. 2001;6(1):28–32.
    1. Sakane M, Fox RJ, Woo SL, Livesay GA, Li G, Fu FH. In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res. 1997;15(2):285–293.
    1. Duthon VB, Barea C, Abrassart S, Fasel JH, Fritschy D, Menetrey J. Anatomy of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2006;14(3):204–213.
    1. Giron F, Cuomo P, Aglietti P, Bull AM, Amis AA. Femoral attachment of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2006;14(3):250–256.
    1. Ferretti M, Ekdahl M, Shen W, Fu FH. Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy. 2007;23(11):1218–1225.
    1. Tsukada H, Ishibashi Y, Tsuda E, Fukuda A, Toh S. Anatomical analysis of the anterior cruciate ligament femoral and tibial footprints. J Orthop Sci. 2008;13(2):122–129.
    1. Ribas GC, Bento RF, Rodrigues AJ., Jr Anaglyphic three-dimensional stereoscopic printing: revival of an old method for anatomical and surgical teaching and reporting. J Neurosurg. 2001;95(6):1057–1066.
    1. Shimizu S, Tanaka R, Rhoton AL, Jr, et al. Anatomic dissection and classic three-dimensional documentation: a unit of education for neurosurgical anatomy revisited. Neurosurgery. 2006;58(5):E1000. discussion E1000.
    1. Ribas GC, Ribas E., Jr RA The brain, the tridimensional vision, and the techniques to obtain stereoscopic images. Rev Med (Sao Paulo) 2006;85:78–90.
    1. Baek GH, Carlin GJ, Vogrin TM, Woo SL, Harner CD. Quantitative analysis of collagen fibrils of human cruciate and meniscofemoral ligaments. Clin Orthop Relat Res. 1998;357:205–211.
    1. Rumian AP, Wallace AL, Birch HL. Tendons and ligaments are anatomically distinct but overlap in molecular and morphological features – a comparative study in an ovine model. J Orthop Res. 2007;25(4):458–464.
    1. Cooper RR, Misol S. Tendon and ligament insertion. A light and electron microscopic study. J Bone Joint Surg Am. 1970;52(1):1–20.
    1. Arnoczky SP. Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res. 1983;172:19–25.
    1. Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res. 1975;106:216–231.
    1. Ellison AE, Berg EE. Embryology, anatomy, and function of the anterior cruciate ligament. Orthop Clin North Am. 1985;16(1):3–14.
    1. Amis AA, Dawkins GP. Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br. 1991;73(2):260–267.
    1. Souryal TO, Moore HA, Evans JP. Bilaterality in anterior cruciate ligament injuries: associated intercondylar notch stenosis. Am J Sports Med. 1988;16(5):449–454.
    1. Kennedy JC, Alexander IJ, Hayes KC. Nerve supply of the human knee and its functional importance. Am J Sports Med. 1982;10(6):329–335.
    1. Adachi N, Ochi M, Uchio Y, Iwasa J, Ryoke K, Kuriwaka M. Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta Orthop Scand. 2002;73(3):330–334.
    1. Scapinelli R. Vascular anatomy of the human cruciate ligaments and surrounding structures. Clin Anat. 1997;10(3):151–162.
    1. Petersen W, Tillmann B. Structure and vascularization of the cruciate ligaments of the human knee joint. Anat Embryol (Berl) 1999;200(3):325–334.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel