TY - JOUR AB - PurposeThe purpose was to clarify the load-bearing functions of the fibers of the femoral anterior cruciate ligament (ACL) attachment in resisting tibial anterior drawer and rotation.MethodsA sequential cutting study was performed on 8 fresh-frozen human knees. The femoral attachment of the ACL was divided into a central area that had dense fibers inserting directly into the femur and anterior and posterior fan-like extension areas. The ACL fibers were cut sequentially from the bone: the posterior fan-like area in 2 stages, the central dense area in 4 stages, and then the anterior fan-like area in 2 stages. Each knee was mounted in a robotic joint testing system that applied tibial anteroposterior 6-mm translations and 10° or 15° of internal rotation at 0° to 90° of flexion. The reduction of restraining force or moment was measured after each cut.ResultsThe central area resisted 82% to 90% of the anterior drawer force; the anterior fan-like area, 2% to 3%; and the posterior fan-like area, 11% to 15%. Among the 4 central areas, most load was carried close to the roof of the intercondylar notch: the anteromedial bundle resisted 66% to 84% of the force and the posterolateral bundle resisted 16% to 9% from 0° to 90° of flexion. There was no clear pattern for tibial internal rotation, with the load shared among the posterodistal and central areas near extension and mostly the central areas in flexion.ConclusionsUnder the experimental conditions described, 66% to 84% of the resistance to tibial anterior drawer arose from the ACL fibers at the central-proximal area of the femoral attachment, corresponding to the anteromedial bundle; the fan-like extension fibers contributed very little. This work did not support moving a single-bundle ACL graft to the side wall of the notch or attempting to cover the whole attachment area if the intention was to mimic how the natural ACL resists tibial displacements.Clinical RelevanceThere is ongoing debate about ho AU - Kawaguchi,Y AU - Kondo,E AU - Takeda,R AU - Akita,K AU - Yasuda,K AU - Amis,AA DO - 10.1016/j.arthro.2014.08.033 EP - 444 PY - 2015/// SN - 0749-8063 SP - 435 TI - The role of fibers in the femoral attachment of the anterior cruciate ligament in resisting tibial displacement T2 - ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY UR - http://dx.doi.org/10.1016/j.arthro.2014.08.033 UR - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000352231100012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202 UR - https://www.sciencedirect.com/science/article/pii/S0749806314007439?via%3Dihub UR - http://hdl.handle.net/10044/1/19589 VL - 31 ER -