Anatomy of the anterior cruciate ligament

Abstract

The anterior cruciate ligament (ACL) is a multifascicular structure whose femoral and tibial attachments, as well as spatial orientation within the knee, are directly related to its function as a constraint of joint motion. The ACL is made up of multiple collagen bundles that give rise to the multifascicular nature of the ligament. This arrangement results in a different portion of the ligament being taut and therefore functional, throughout the range of motion. The ACL receives its blood supply from branches of the middle genicular artery, which from a vascular synovial envelope around the ligament. These periligamentous vessels penetrate the ligament transversely and anastomose with a longitudinal network of endoligamentous vessels. The body attachments do not contribute significantly to the vascularity of the ligament. The nerve supply to the ACL originates from the tibial nerve. Although the majority of fibers appear to have a vasomotor function, some fibers may serve a proprioceptive or sensory function.