The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament - Part 1: Tibial attachment

The tibial attachments of the individual anteromedial (AM) and posterolateral (PL) fibre bundles and the entire attachment of the anterior cruciate ligament are described, relating them to consistent bony landmarks; 55 fresh-frozen specimens were measured. The fibre bundles were separated and excised at their attachments and their peripheries marked with a pen. High-resolution scaled digital photographs were taken of each dissected specimen and transferred onto a computer for analysis. A wide variation was found when using the posterior tibial axis, the anterior tibial surface and the medial tibial spine as reference points. The most consistent measurements used the tibial interspinous over-the-back ridge as a datum. The attachments of the PL and AM bundles were centred 10 +/- 1 mm (mean +/- SD) and 17 +/- 2 mm anterior to the over-the-back ridge. They were 4 +/- 1 and 5 +/- 1 mm, respectively, lateral to the medial tibial spine border. The positions of 6 mm circles in the posterior-medial limits of the fibre bundles (representing tunnels in a double-tunnel reconstruction) were measured. The overall dimensions of the tibial plateaux correlated significantly with many measurements. The results from this study could be used to guide ACL reconstruction techniques.