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S. ZAFFAGNINI, G. CARBONE, A. GRASSI, F. RAGGI, T. ROBERTI DI SARSINA, C. SIGNORELLI
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angle of knee flexion, but analysing contribution
of each area in resisting to anterior tibial
displacement they founded that the central
direct insertion area plays a primary role in
knee antero-posterior stability. According to
them the most important fibers to reproduce the
action of the ACL to resist tibial anterior
displacement attach to the central/proximal
part of the femoral insertion, corresponding
approximately to the AM fiber bundle. So, on
these bases, the graft in ACL reconstruction
should be located near the roof of the femoral
intercondylar notch, at the centre of effort of
ACL sited at mean of 2 hours 2 minutes
±18minutes (clock-face position), when
viewed through the intercondylar notch from
posterior to anterior, parallel to the roof of the
notch (Blumensaat’s line). This position is
similar to the over-the-top position, as showed
by MRI imaging (fig. 1a-1b).
ACL behaviour during passive range of motion
was investigated by Zaffagnini
et al.
[6]. They
found a very characteristic behaviour,
inasmuch as the angles, that two bundles of
ACL create with tibial plateau and femoral
Fig. 1:
The center of effort
of the ACL is located at
mean of 2 hours 2 minutes
±18minutes
(clock-face
position), when viewed
through the intercondylar
notch from posterior to
anterior, parallel to the roof
of the notch (Blumensaat’s
line) [5] (
a
). This position is
similar to the over-the-top
position, as showed by MRI
imaging (
b
).
a
b