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The morphology of the tibial footprint of the anterior cruciate ligament changes with ageing from oval/elliptical to C-shaped

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To further the current understanding of the modifications of the morphology of the ACL tibial footprint in healthy knees during the ageing process. The hypothesis is that there are differences in the morphology of the ACL tibial footprint between the cadavers of the young and elderly due to a degenerative physiological process that occurs over time.

Methods

The tibial footprint of the ACL was dissected in 64 knee specimens of known gender and age. They were divided into four groups by age and gender, setting 50 years of age as the cut-off point. Three observers analyzed the tibial footprint dissections and the shape was described and classified.

Results

The knees from the cadavers of males older than 50 years of age presented a “C” morphology in 85% of the cases. In the group of males aged less than 50 years, an oval/elliptical morphology was found in 85.7% of the cases. In the group of women over 50 years-old, the “C” morphology was observed in 82.3% of the cases. In women under the age of 50, the oval/elliptical morphology was found in 84.6% of the cases. A significant difference was observed between the prevalence rates of the morphologies of the younger and older groups (p < 0.001 for both genders). However, no differences were observed between males and females of the same age group (n.s.).

Conclusions

The morphology of the tibial footprint of the ACL presents significant variations with ageing. It can go from an oval/elliptical shape to a “C” shaped morphology. The results of this work make for an advance in the individualization of ACL reconstruction based on the age and the specific morphology of the tibial footprint.

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Acknowledgements

To all the technical and administrative staff of the Anatomy Departments of the UANL School of Medicine and Dentistry for their valuable help in carrying out this study. To Dr. Francisco Barrera Flores, Statistical Professor of the Research Department of the UANL School of Medicine for the methodological support provided for this study and Mr. Eric Lawynn Goode for the revision and edition of the manuscript in English.

Funding

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Author information

Authors and Affiliations

  1. Knee Unit, Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, University Hospital “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León (U.A.N.L.), 4thFloor, Central Building of the University Hospital, Av. Francisco I. Madero y Av. Dr. Eduardo Aguirre Pequeño, s/n Col. Mitras Centro, 64460, Monterrey, Nuevo León, México

    Rodolfo Morales-Avalos, Tadeo A. Castillo-Escobedo, Víctor M. Peña-Martínez & Félix Vílchez-Cavazos

  2. Department of Human Anatomy, Faculty of Medicine, Universidad Autónoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, México

    Rodrigo E. Elizondo-Omaña & Santos Guzmán-López

  3. Department of Human Anatomy, Faculty of Dentistry, Universidad Autónoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, México

    María del Carmen Theriot-Giron

  4. Knee and Arthroscopy Unit, ICATME, Hospital Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain

    Rodolfo Morales-Avalos, Simone Perelli & Juan Carlos Monllau

  5. Department of Orthopaedic Surgery, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain

    Juan Carlos Monllau

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  1. Rodolfo Morales-Avalos
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  2. Tadeo A. Castillo-Escobedo
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  9. Juan Carlos Monllau
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Corresponding author

Correspondence to Rodolfo Morales-Avalos.

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Each author certifies that neither he or she, or any member of his or her immediate family has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Other forms of conflict of interest of only one of the authors (JCM) that are not related to the publication of this article can be consulted in the COI forms that were sent to the journal.

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Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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The present protocol was approved by the Institutional review board of the Faculty of Medicine and University Hospital “Dr. José Eleuterio Gonzalez” of the Universidad Autonoma de Nuevo Leon (Monterrey, Mexico) with the registration number: OR16-00007.

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Morales-Avalos, R., Castillo-Escobedo, T.A., Elizondo-Omaña, R.E. et al. The morphology of the tibial footprint of the anterior cruciate ligament changes with ageing from oval/elliptical to C-shaped. Knee Surg Sports Traumatol Arthrosc 29, 922–930 (2021). https://doi.org/10.1007/s00167-020-06049-7

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