Cortical bony thickening of the lateral intercondylar wall : the functional attachment of the anterior cruciate ligament

Background:The anatomy of the anterior cruciate ligament (ACL) has become the subject of much debate. There has been extensive study into attachment points of the native ligament, especially regarding the femoral attachment. Some of these studies have suggested that fibers in the ACL are of differing functional importance. Fibers with higher functional importance would be expected to exert larger mechanical stress on the bone. According to Wolff’s law, cortical thickening would be expected in these areas.Purpose:To examine cortical thickening in the region of the ACL footprint (ie, the functional footprint of the ACL).Study Design:Descriptive laboratory study.Methods:Using micro–computed tomography with resolutions ranging from 71 to 91 μm, the cortical thickness of the lateral wall of the intercondylar notch in 17 cadaveric knees was examined, along with surface topography. After image processing, the relationship between the cortical thickening and surface topology was visually compared.Results:A patter...