Intraarticular Rupture Pattern of the ACL.Zantop, Thore MD*; Brucker, Peter U MD; Vidal, Armando MD; Zelle, Boris A MD; Fu, Freddie H MD† Section Editor(s): Fu, Freddie H MD, Guest Editor; Zelle, Boris MD, Guest EditorAuthor Information From the *Department of Trauma, Hand and Reconstructive Surgery, Wilhelms University Muenster, Germany; and the †Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained (IRB #0505139). Correspondence to: Thore Zantop, MD, Department of Trauma, Hand and Reconstructive Surgery, University of Muenster, Waldeyer Strasse 1, 48149 Muenster, Germany. Phone: 00149-251-8356301; Fax: 00149-251-8356318; E-mail: [email protected] Clinical Orthopaedics and Related Research (1976-2007): January 2007 - Volume 454 - Issue - pp 48-53 doi: 10.1097/BLO.0b013e31802ca45b Buy Metrics Abstract To date, the intraarticular rupture pattern of the anterior cruciate ligament (ACL) has not been reported. The ACL is a complex structure consisting of two functionally synergistic structures: the anteromedial (AM) and posterolateral (PL) bundle. The purpose of our study was to evaluate the intraarticular rupture pattern of the ACL with regard to its two functional bundles. We examined ACL rupture patterns with regard to the integrity of AM and PL bundle in 121 consecutive patients undergoing anterior cruciate ligament reconstruction surgery within 120 days after injury. The intraarticular pattern was observed by one experienced surgeon. In 25% of the patients a partial rupture of the ACL was found, whereas in the remaining 75% a complete rupture of AM and PL bundles was seen. A partial rupture could only be detected by careful dissection of the ligament. In 44% of all patients the AM and PL bundles did not rupture at the same location. In 12% of the patients the PL bundle showed no signs of rupture. When performing ACL reconstruction, care should be taken when dissecting down the ACL remnants to evaluate intact fiber bundles of the ACL. Level of Evidence: Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence. © 2007 Lippincott Williams & Wilkins, Inc.