title: Anatomical analysis of the anterior cruciate ligament femoral and tibial footprints.
abstract: BACKGROUND
  The current trend in anterior cruciate ligament (ACL) reconstruction has shifted to anatomical double-bundle (DB) reconstruction, which reproduces both the anteromedial bundle (AMB) and the posterolateral bundle (PLB) of the ACL. Navigation systems have also been recently introduced to orthopedic surgical procedures, including ACL reconstruction. In DB-ACL reconstruction, the femoral and tibial tunnel positions are very important, but a representation of the ACL footprint under an arthroscopic view has not been established even though navigation systems have been introduced. The purpose of this study was to evaluate the anatomical footprints of both the AMB and the PLB using the representation method for application to arthroscopic DB-ACL reconstruction using a navigation system, and to evaluate the validity of the currently determined footprint position compared with other representation methods.
  
  
  METHODS
  Thirty-six cadaveric knees were used for an anatomical evaluation of footprints of the AMB and PLB. On the tibial side, the ACL footprints were evaluated using an original method. On the femoral side, the ACL footprints were evaluated using Watanabe's method and three other methods: (1) the quadrant method, (2) Mochizuki's method, and (3) Takahashi's method.
  
  
  RESULTS
  The central points of the ACL footprints were represented almost constantly. The present data is in accordance with previous measurement data.
  
  
  CONCLUSIONS
  This study showed that the anatomical data of the ACL femoral and tibial footprints determined with Watanabe's method at the femoral side and our original method at the tibial side were both applicable to arthroscopic surgery with a navigation system.
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, 036-8562, Japan.
authors.forename: Harehiko
authors.initials: H
authors.lastname: Tsukada
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tsuda
authors.forename: Akira
authors.initials: A
authors.lastname: Fukuda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Toh
mesh_terms: D000368:Aged; D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology*; D000886:Anthropometry; D001696:Biomechanical Phenomena; D002102:Cadaver; D005269:Femur / Q000033:anatomy & histology*; D006801:Humans; D007719:Knee Joint / Q000033:anatomy & histology*; D012016:Reference Values; D013977:Tibia / Q000033:anatomy & histology*