Anatomical Research on the Anterior Cruciate Ligament of the Knee

ObjectiveThe Ribbon Theory challenges the traditional perspective that the anterior cruciate ligament (ACL) consists of a two-bundle structure, specifically the anterior inner bundle and the posterior outer bundle. Consequently, there is a pressing need to conduct further anatomical studies of the ACL to furnish a more precise anatomical foundation for ACL reconstruction procedures. Materials and MethodsA total of 30 fresh knee specimens, sourced from donor cadavers utilized for educational purposes, were dissected. The morphology of the ACL was observed, and its length, insertion position, and surface area were systematically measured.In males, the mean length of the right ACL was 34.52 mm, while the left ACL measured an average of 34.87 mm. In females, the mean length of the right ACL was 30.8 mm, and the left ACL averaged 30.53 mm. The average femoral footprint area on the right side was 143 mm2 {+/-} 16 for males and 124 mm2 {+/-} 21 for females, whereas on the left side, it was 145 mm2 {+/-} 22 for males and 123 mm2 {+/-} 17 for females. In conclusion, the majority of ACLs are characterized by a single flat band extending from the femoral origin to the midpoint, with no distinct separation observed at the midpoint. This discovery has significantly influenced the techniques used in ACL reconstruction, advancing the development of the anatomical single-bundle ACL reconstruction method.