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Abstract Presented at the 26th Annual Meeting of the Arthroscopy Association of North America| Volume 23, ISSUE 6, SUPPLEMENT , e6, June 2007

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Tunnel Positioning of AM and PL Bundle in Anatomic ACL Reconstruction (SS-10)

      Summary

      The centre of the femoral PL bundle is shallow and inferior to the AM bundle. To reproduce the anatomy, it is mandatory to place the tunnels exactly within the femoral origin and tibial insertion of the ACL.

      Purpose

      Aim of the current study was to provide anatomical details of AM and PL bundle of the ACL giving guideline for tunnel positioning in anatomical ACL reconstructions.

      Methods

      A total of 20 human cadaveric knees (range 45-87 years) were dissected and the the medial femoral condyle cut to expose the ACL. The bundles were separated due to their tensioning pattern and the distances of the centre of AM and PL bundle to the articular cartilage were measured. Radiographic analyses were performed using the techniques of Bernard and Hertel and Harner at the femur as well as the method by Harner and Stäubli and Rauschning at the tibia.

      Results

      The center of the PL bundle was more shallow and inferior when compared to the center of the AM bundle with a distance of 6.5 mm and a mean of 5.8 mm to the shallow and inferior cartilage margin, respectively. On the tibia, the center of the AM bundle is aligned with the anterior horn of the lateral meniscus. According to Bernard and Hertel the center of the AM bundle is at 18.5% and 22.3% and the PL bundle at 29.3% and 53.6%. At the tibia, the centre of the AM bundle is at 30% and the PL bundle is located at 44% according to Stäubli and Rauschning.

      Conclusions

      The centre of the femoral PL bundle is shallow and inferior to the AM bundle. To reproduce the anatomy, it is mandatory to place the tunnels exactly within the femoral origin and tibial insertion of the ACL.