hment is slightly tilted forward from the vertical. The posterior convexity is "parallel to the posterior articular margin of the lateral femoral condyle" (4:132-133). The ACL is distally attached to a fossa in front of and lateral to the anterior tibial spine. Here the ACL passes under the transverse meniscal ligament; fascicles of the ACL may blend with the anterior attachment of the lateral meniscus. For some, fascicles from the posterior part of the tibial attachment of the ACL may blend with the posterior attachment of the lateral meniscus. The tibial attachment is broader than the femoral attachment. The ACL fans out and terminates in a larger tibial attachment than that with the femoral attachment (nearly twice the width). There is a part right at the tibial attachment that lies against and adapts to the contour of the intercondylar roof while the joint is in full extension (4:133).
The ACL courses anteriorly, medially, and distally across the joint and passes from femur to tibia. It turns on itself in an outward spiral, probably due to its bony attachments. The ACL is attached to the femur and tibia as a collection of individual fascicles rather than a singular cord; they fan out over a broad, flat area. The fascicles are divided into the anteromedial band (AMB) and the posterolateral band (PLB). The AMB originate at the proximal part of the femoral attachment and insert at the anteromedial part of the tibial attachment. The PLB are the rest of the fascicles inserted at the posterolateral part of the tibial attachment. In a normal ACL, fibers have a unique point of origin and insertion; they are not parallel and do not have the same length (4:134).
Studies show that ACL is composed of multiple wide collagen fiber bundles separated by columns of cells in fibrous capsules which group into fascicles varying in size. Others liken cruciate ligaments to that of the tendon; collagen fibrils group into fibers and m...