Anatomical Study Of The Anterior Cruciate Ligament And Revascularization

Objective:In this study,anatomical data of the anterior cruciate ligament and related regions were collected from gross specimens and MRI imaging,respectively.It included length,width,the diameter of the insertion point,as well as the angle of inclination and the width of the intercondylar notch.The anatomic parameters of anterior cruciate ligament in Jilin area were obtained,and the relationship between ACL anatomic parameters and postoperative knee motor function was analyzed by comparing with the data of patients after ACL reconstruction.To provide theoretical basis and data support for clinical anatomical study and clinical improvement of ACL reconstruction ligament placement sites and prognosis.Materials and methods:1.Human specimen informationA total of 10 normal adult knee joint specimens(20 sides)were collected,including 8 males and 2 females,all from the Department of Human Anatomy,School of Basic Medicine,Jilin University.According to the basic anatomical operation,the femur and tibia and fibula were separated and cut off 10 cm above and below the patella.The skin superficial fascia and each layer of muscle were separated layer by layer,and the complete anterior cruciate ligament and knee joint surface were obtained by cleaning.The medial femoral condyle was resected,the anterior cruciate ligament was exposed,the knee joint was restored to 0°,and the anterior cruciate ligament parameters were measured with a vernier caliper.The range of the anterior cruciate ligament insertion was marked,the ligament was removed to expose the lateral femoral condyle and the articular surface of the tibial plateau,and the ligament insertion was measured with a vernier caliper.2.Videography informationThis study collected lower extremity MRI scan images of patients who were treated at the Sino-Japanese Friendship Hospital of Jilin University between July 2020 and May 2021.They were divided into normal adult group and anterior cruciate ligament reconstruction group.According to the inclusion and exclusion criteria and with the informed consent of the patients,82 patients with 164 sides in the MRI normal adult group,including 58 males and 24 females,with an average age of46 years;58 patients in the anterior cruciate ligament reconstruction group,including 41 males,There were 17 females with an average age of42 years.Routine data collection was performed according to the operating procedures of the Sino-Japanese Friendship Hospital of Jilin University and the equipment requirements of the Mangetom Skyra 3.0T superconducting magnetic resonance scanner,and the lower limb MRI datas were uploaded to the workstation.Then,the images were screened and processed,and the appropriate window width and height of the knee joint area were selected.3D reconstruction,analysis and measurement of bones and anterior cruciate ligament were carried out with the software on the workstation.3.Follow-up informationThe data of knee joint function recovery of patients 6 months after operation were collected by filling in Lysholm score and IKDC score scale.4.The general measurement data of the specimens were all measured three times and the average value was obtained.The imaging data was analyzed and measured using the workstation’s own software SPSS 25.0 statistical analysis software was used for analysis,expressed (?) ±S,and P<0.05 was considered to be statistically significant.Results:1.There was no significant difference in the length and width of the anterior cruciate ligament between the cadaveric specimen group and the normal adult MRI group.Similar results were also found for the length,width,and area of the femoral and tibial insertions of the anterior cruciate ligament.2.The average width of the intercondylar notch in normal adults is16.52±2.85 mm,the maximum value is 20.69 mm,and the minimum value is 12.32 mm.3.There was no significant difference in the anterior cruciate ligament slope angle between the normal adult MRI group and the MRI group after ACL reconstruction.4.The femur insertion point of the anterior cruciate ligament was divided into quarters according to the long axis,and the sagittal views were named as zones 1 to 4 from anterior to posterior.The center of the transplanted ligament was located in zone 2 and zone 3,especially zone 2,which accounted for 55.2%.5.The tibial insertion point of the anterior cruciate ligament was divided into quarters according to the left and right diameters,and divided into 1 to 4 zones from the inside to the outside.The center of the graft ligament was located in zone 2 and zone 3,reaching 39.7% and43.1%,respectively.6.The Lysholm score and IKDC score of patients after anterior cruciate ligament reconstruction were 81.63±28.92 and 71.84±31.63,respectively.7.There were significant differences in Lysholm score and IKDC score between groups with a change of more than 15° in coronal angle after ACL reconstruction,compared with a group which changed less than 10° or changed about 10°-15°.8.There were significant differences in Lysholm score and IKDC score between groups with a change of more than 15° in sagittal angle after ACL reconstruction,compared with a group which changed less than 10° or changed about 10°-15°.Conclusion:1.In anterior cruciate ligament reconstruction,the center of the femoral insertion of the transplanted ligament is mostly located in the sagittal mid-anterior area of the original insertion,and the center of the tibial insertion is mostly located in the middle of the original tibial insertion.2.After anterior cruciate ligament reconstruction,the ligament inclination angle changed more than 15°,and the knee joint motor function changed significantly.