Anatomy of the Knee Joint and the ACL

There is a mesentery-like shut up of synovium which starts from the underside intercondylar area and envelops both ACLs and posterior symmetric ligaments (PCLs). Cruciate ligaments are intraarticular and extrasynovial (4:132).

The ACL is tie to a fossa on the posterior aspect of the medial surface of the squint-eyed femoral condyle. The femoral attachment is a segment of a lick with a straight precedent border and a convex posterior border. The long axis of the femoral attachment is just about tilted forward from the vertical. The posterior convexity is "parallel to the posterior articular margin of the lateral femoral condyle" (4:132-133). The ACL is distally attached to a fossa in front of and lateral to the antecedent tibial spine. Here the ACL passes under the transverse meniscal ligament; fascicles of the ACL may croak with the anterior attachment of the lateral meniscus. For some, fascicles from the posterior part of the tibial attachment of the ACL may blend with the posterior attachment of the lateral meniscus. The tibial attachment is broader than the femoral attachment. The ACL fans out and terminates in a larger tibial attachment than that with the femoral attachment (nearly twice the width). There is a part right at the tibial attachment that lies against and adapts to the contour of the intercondylar roof while the joint is in full extension (4:133).

The ACL courses anteriorly, medially, and distally across the joint and passes from femur

9. Holden, J. P.; Grood, E. S.; Korvick, D. L.; Cummings, J. F.; Butler, D. L.; Bylski-Austrow, D. I. In vivo forces in the anterior cruciate ligament: direct measurements during walking and trotting in a quadruped. J. Biomechanics 27(5):517-526; 1994.

The distaff genu is more cruciate-dependent than the male. Secondary restraints (particularly the hamstrings and posterior capsule) can at reduced loads compensate for a knee with a positively charged Lachman and negative pivot shift. For cruciate-dependent people with cruciate ligament injuries, nonsurgical treatment is more likely to fail; surgical reconstructions are usually the most useful for returning a ligament-dominant soulfulness to sport.

Current studies are continuing to investigate factors of alignment, gait, skills, electromyographic parameters, force plate, and specialism for ACL injury (11:296).

In a study of 147 patients with arthroscopically proved continuing injuries of the ACL, the reliability of the anterior drawer streak, the Lachman psychometric test, and the pivot shift test was demonstrated preoperatively and under anesthesia. Findings showed that the anterior drawer test was positive in 79.6 per centum of patients, in 98.6 percent for the Lachman test, and in 89.8 percent of those having the pivot shift test. In 12.9 percent of the cases, arthroscopic examination showed reattachment of the proximally bust end of the ACL to the posterior cruciate ligament. For these patients the anterior drawer test was positive in 68.4 percent of patients, in 89.5 percent of those having the Lachman test, and in 63.2 percent with the pivot shift test (14:237).

21. Mommersteeg, T. J. A.; Huiskes, R.; Blankevoort, L.; Kooloos, J. G. M.; Kauer, J. M. G. An inverse dynamics modeling approach to influence the restraining function of human knee ligament bundles. J. Biomechanics 30(2):139-146; 1997.

Clinical examination first consists of knee inspection to determine if there is a joint effusion (hemarthrosis) or secernate of co
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