Anatomy of the cruciate ligaments and their function in extension and flexion of the human knee joint

Abstract

The areas of the femoral origin of the cruciate ligaments have approximately the shape of sectors of ellipses, the one for the anterior ligament on the lateral condyle posteroproximally and the one for the posterior ligament on the medial condyle distally. By means of a new technique of dissection, combined with the use of X-rays, the change in distance between the origin and insertion and so the change of tension of single bundles of the ligaments could be analyzed. Only a rather thin bundle in each cruciate ligament is in constant tension: “guiding bundles.” The maximal diminution of distance between the origin and insertion for some bundles is 65%. In the anterior cruciate ligament the majority of fibers are taut in extreme extension: “limiting bundles.” The same is true in the posterior cruciate ligament in extreme flexion. There are also some fibers, especially in the posterior cruciate ligament, that are taut only in an intermediate position. The geometric analysis of the function of different groups of fibers was performed by a modification of Menschik's concept of a four-bar link.