Length difference of anteromedial and posterolateral bundles of anterior cruciate ligament in flexion and extension (Cadaver study)

Aim: We aimed to measure lengths of both anteromedial(AM) and posterolateral(PL) bundles of anterior cruciate ligament(ACL) in flexion and extension, and analyse statistically.Material and Method: 20 knees of 10 human cadavers were studied in Republic of Turkey Ministry Of Justice Forensic Medicine Institiute. All the subjects were male (100%). An anterior longitudinal incision was made and After passing subcutaneus tissue, knee joint was visualized with a medial parapatellar approach. Lengths of both anteromedial and posterolateral bundles of anterior cruciate ligament in flexion and extension were measured in milimeters with flexible ruler scale. Data was analysed statistically. Wilcoxon test was used for statistical analysis.Results: Mean age was 46.5 (32-62). A statistically significant difference was seen in lengths of both AM and PL bundles of anterior cruciate ligament in flexion and extension (p<0,05). Difference in lentghs of bundles of AM and PL in flexion and extension is statistically significant. Whereas, any statistical difference was not noted in comparison of length differences among bundles during flexion and extension (z=0,085, p=0,932).Discussion and Conclusion: Difference in lentghs of bundles of AM and PL in flexion and extension was seen statistically significant in our study. In single-bundle technique, only anteromedial bundle of anterior cruciate ligament is reconstructed. Besides, both anteromedial and posterolateral bundles of anterior cruciate ligament are reconstructed in double-bundle technique. We consider that ACL reconstruction with double-bundle technique is more relevant to functional anatomy and in favor of higher stability. AM and PL bundles have distinct features and lengths in different flexion degrees. We emphasize to review this entity while determining reconstruction technique for ACL-deficient patients.Key Words: Anterior cruciate ligament, anteromedial bundle, posterolateral bundle, length difference.