POSTER ABSTRACTS - ISAKOS

microscopically found, we classified the ligaments
into the microscopic double bundle group (group
B). Finally, the ligaments in which we could not
detect double bundles were classified as the
single bundle group (group C).
2. Investigation of the femoral and tibial
insertion of ACL
Morphological investigation was performed at
the points of insertion of the ACL into the femur
and tibia. We classified them into three
morphological types, including two separate
insertion type. One of these had two insertions of
double bundles, which were adjoined each other.
This was named the adjoining separate insertion
type (type 1). The second type was the completely
separate insertion type (type 2), in which we
clearly detected the separation between two
insertions. The third was the common insertion
type (type 3). This type showed common insertion
of the anteromedial and posterolateral bundles.
1. Investigation of the midsubstance of ACL
Group A contained 26 knees (55.3%). Groups B
and C had a combined 21 knees (46.7%). There
were 9 knees (19.9%) in group B and 12 knees in
group C. Three cadavers which had group A knees
on one side had group C knees on the other side.
2. Investigation of the femoral and tibial insertion
of ACL
Twenty-two knees (46.8%) on the femoral side
and 26 (55.3%) on the tibial side were type 1.
There were four type 3 knees in group A on the
femoral side, and 25 knees on the femoral side
and 21 on the tibia were type 3. We did not find
any type 2 knees.
ACL has long been a topic of interest among
orthopedic surgeons and numerous studies have
been reported on the anatomy and function of the
ACL. Girgis (1975) and Arnorczky (1983) devided
the ACL into two parts: a small anteromedial and
a large posterolateral band. Muneta (1997)
described the double bundle procedure for the
ACL reconstruction and Yasuda (2003) showed the
anatomical, biomechanical, clinical studies about
the anteromedial and posterolateral band of the
ACL.
Many orthopedic surgeons recognize that all
ACLs are two strands and all insertions of the ACL
on the femur and tibia are completely separated.
In this study, however, we clarified only 75% in all
knees were double bundles and no completely
separated insertions of the ACL were detected in
both femur and tibia.
Double bundles ACL reconstruction with
hamstrings placed on the completely separate
insertion dose not mean a true anatomical
reconstruction.
E-poster #157
The Relationship of the Glenoid Notch Angle
and the Attachement of the Antero-superior
Labrum
Karin van Rooyen, Cape Town, SOUTH AFRICA,
Christo J.F. Muller, Tygerberg, Western Cape,
SOUTH AFRICA
Don F. du Toit, Tygerberg, SOUTH AFRICA
W Jaap Willems, Bergen, NETHERLANDS
Joe F De Beer, Panorama, Cape Town, SOUTH
AFRICA
Cape Shoulder Institute, Cape Town, SOUTH
AFRICA
INTRODUCTION:
The shape of the glenoid can vary between a pearshape
and an oval-shape depending on the
presence of a glenoid notch.
We measured the angle between the superior and
inferior part of the anterior glenoid rim (Glenoid
Notch Angle ) and investigated its relationship
with the labral attachment to the glenoid at that
location.
METHODS:
53 embalmed cadaver shoulders were used in this
study.
The attachment of the anterosuperior labrum at
the site of the glenoid notch was observed and
assessed as 1)tight, 2)loosely attached or
3)sublabral foramen.
Then the anterior labrum was removed and digital
images perpendicular to the glenoid notch were
taken.
With a digital image analysis program the angle of
the glenoid notch was measured.
RESULTS:
The attachment of the labrum at the site of the
glenoid notch was assessed as tight in 37 (70%),
loose in 8 (15%) and in 8 (15%) shoulders a
sublabral foramen was found.
The mean glenoid notch angles for the loosely
attached group was 153 degrees, for the sublabral
foramen group 159 degrees and 168 degrees for
the group with a tight attachment.
The angle of the glenoid notch for the
loosely/sublabral foramen group was significantly
less than for the tight group.
Presence of a glenoid notch was only noted when
the glenoid notch angle was less than 170
degrees.
CONCLUSION: