(Fig 2-A.01) Surgical Anatomy of ACL and Associated Ridges

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★ Surgical anatomical structures related to the ACL ★

1️⃣ Lateral Intercondylar Ridge:

• This structure is found anterior to the ACL femoral footprint, with an average length of 18.0 mm.
  
• It stretches from the femoral articular cartilage margin to the roof of the intercondylar notch.

 

2️⃣ Lateral Bifurcate Ridge:

• Situated between the AM (anteromedial) and PL (posterolateral) bundles of the ACL, this ridge runs relatively perpendicular to the lateral intercondylar ridge.
• It extends from the lateral intercondylar ridge to the posterior articular cartilage margin, with an average length of 11.6 mm.
• It separates the AM and PL bundles at their femoral attachments, aligning superior to inferior in a knee flexed at approximately 90°, which translates to an anterior-to-posterior direction when the knee is extended.

 

★ ACL ★

 

• A normal ACL presents a striated appearance and runs parallel to Blumensaat’s line, which marks the roof of the intercondylar notch.
  
• The ACL attaches on the inner (medial) side of the posterolateral femoral condyle.
  
• In an extended knee position, the AM bundle fibers originate anteriorly and proximally, while the PL bundle comes from the posterolateral side.
• On sagittal images, the two bundles of the ACL are not distinctly separable, with the anterior margin possibly appearing darker and thicker, indicative of the AMB (anteromedial bundle).
• The PL bundle may display higher signal intensity compared to the AM bundle.

 

 

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