1. Lateral Intercondylar Ridge: Is it a reliable landmark for femoral ACL insertion?: An anatomical study
- Author
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A. Ker, Quentin A. Fogg, Simon J. Spencer, Rahul Bhattacharyya, and Jibu Joseph
- Subjects
Cartilage, Articular ,Knee Joint ,Anterior cruciate ligament reconstruction ,medicine.medical_treatment ,Anterior cruciate ligament ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Cadaver ,medicine ,Humans ,Femur ,Anterior Cruciate Ligament ,030222 orthopedics ,Anterior Cruciate Ligament Reconstruction ,business.industry ,Soft tissue ,030229 sport sciences ,General Medicine ,Anatomy ,musculoskeletal system ,Ridge (differential geometry) ,surgical procedures, operative ,medicine.anatomical_structure ,Surgery ,Cadaveric spasm ,business - Abstract
Background Incorrect femoral tunnel placement is the most common cause of graft failure during Anterior Cruciate Ligament (ACL) Reconstruction. A reliable landmark can minimize errors. Aim To identify whether the Lateral Intercondylar Ridge (LIR) is a consistent anatomical structure and define its relationship with the femoral ACL insertion. Materials and methods Phase 1: we studied 23 femoral dry bone specimens macroscopically. Using a digital microscribe, the medial surface of the lateral femoral condyle was reconstructed (3D) to evaluate whether there was an identifiable bony ridge. Phase 2: 7 cadaveric specimens with intact soft tissues were dissected to identify the femoral ACL insertion. A 3D reconstruction of the femoral ACL insertion and the surface allowed us to define the relationship between the LIR and the ACL insertion. Results All specimens had a defined LIR on the medial surface of the lateral femoral condyle. The ridge was consistently located just anterior to the femoral ACL insertion. The ACL footprint was present in the depression between the ridge and the Inferior Articular Cartilage Margin (IACM). The mean distance from the midpoint of the IACM to the LIR was 10.1 mm. Conclusions This is the first study to use the microscribe to digitally reconstruct the medial surface of the lateral femoral condyle. It shows that the LIR is a consistent anatomical structure that defines the anterior margin of the femoral ACL insertion, which guides femoral tunnel placement. Our findings support the ruler technique, which is a commonly used method for anatomic single bundle ACL reconstruction.
- Published
- 2018
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