Locating femoral graft placement from lateral radiographs in anterior cruciate ligament reconstruction: a comparison of 3 methods of measuring radiographic images

Klos, Tiburtius V S; Harman, Melinda K.; Habets, Raymond J.E.; Devilee, Roger J.J.; Banks, Scott

doi:10.1053/jars.2000.4634

Cited by 48 publications

(47 citation statements)

References 22 publications

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“…Fluoroscopically-assisted locating methods have been reported to increase the accuracy of graft placement [1,3,8,10,21,23], and they are especially helpful to locate the femoral tunnel [17]. Of the most frequently used methods, Amis' method has been proven to be more accurate and repeatable than Harners and Aglieffi's [21]. But only one landmark had been used to locate the centre of attachment.…”

Section: Discussionmentioning

confidence: 99%

“…Capsule, posterior cruciate ligament, and fat pad were removed, and femur and tibia were preserved 20 cm from the joint line. Femoral condyles were split from the middle as Klos described [21]. The femoral insertion site of ACL was discerned and marked with metal wires (5 mm in length and 1 mm in diameter).…”

Section: Methodsmentioning

confidence: 99%

“…Consistent measurements documenting femoral graft placement in ACL reconstruction are difficult to obtain. Only the measurement techniques described by Amis produced substantially reliable data [21]. Up to now, there is no universal roentgenographic method widely accepted.…”

Section: Introductionmentioning

confidence: 99%

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Roentgenographic measurement study for locating femoral insertion site of anterior cruciate ligament: a cadaveric study with X-Caliper

Guo

Yang

Wang

et al. 2008

International Orthopaedics (SICO

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The purpose of this study was to determine the relationships of the anterior cruciate ligament (ACL) femoral insertion site with femoral bony landmarks and develop a new method of location. Sixteen unpaired normal Chinese human cadaveric knees were used. Femoral insertion sites of the ACL were marked with metal wires. Four pairs of bony landmarks were selected: anatomical axis of distal femur (A) and parallel tangent of posterior condyles (B); tangent of anterior condyles parallel to landmark A (C) and landmark B; Blumensaat's line (D) and parallel tangent of distal condyles (E); and tangent of posterior condyles (F) and parallel tangent of anterior condyles (G). The X-Caliper was used to measure the distance between the centre of the insertion site and each pair of bony landmarks. The ratio of distances to each pair of bony landmark was calculated. Clock position of the ACL femoral footprint was measured on anteroposterior (AP) roentgenograms at 90 degree flexion. The centre of the ACL footprint was found at 65.3% ± 1.1% between A and B, 78.1% ± 1.0% between B and C, 38.3% ± 2.7% between D and E, and 43.1% ± 4.6% between F and G. The distances to bony landmarks A, B, D, and E have smaller variations. Blumensaat's line and the anatomical axis of the distal femur were regarded as more useful and made location of the insertion site more precise. A parallelogram made up of these two bony landmarks can be used. On AP roentgenograms, the centre of the femoral footprint should be moved to lower than the 10:00 o'clock (2:00) position.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Roentgenographic measurement study for locating femoral insertion site of anterior cruciate ligament: a cadaveric study with X-Caliper

Guo

Yang

Wang

et al. 2008

International Orthopaedics (SICO

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“…The circle based on the posterior femoral condyle can be used for accurate navigation, in relation to shallow-deep and high-low coordinates. Amis et al [1] reported this method in 1994, and Klos et al [14] modified it for use with lateral radiographs. In this study this method yielded small standard deviations for bundle positions (approximately 2-3 mm) that, particularly in the high-low direction, correlated with the posterior condyle diameter.…”

Section: Discussionmentioning

confidence: 99%

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

Edwards

Bull

Amis

2007

Knee Surg Sports Traumatol Arthr

200

191

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The aim of this study was to describe the anatomical locations of the femoral attachments of the anteromedial (AM) and posterolateral (PL) bundles of the anterior cruciate ligament (ACL). Twenty-two human cadaver knees with intact ACLs were used. The femoral attachments of the two bundles were identified, marked and photographed. They were measured and described in terms of the o'clock positions parallel to the femoral long axis and parallel to the roof of the intercondylar notch. The centres of the bundles were also measured in a high-low and a superficial-deep manner referencing from the centre of the posterior femoral condyle, and with respect to their positions within a measurement grid defined in this study. The bulk of the AM bundle was attached between the 9.30 and 11.30 o'clock positions and the PL bundle between the 8.30 and 10 o'clock positions. The AM and PL bundles were consistently found in specific zones of the measurement grid. Using the posterior condyle reference method, the centre of the AM bundle was at 68 ± 7% (range 57-78) in a shallow-deep direction and 55 ± 5% (44-62) in a high-low direction. The PL bundle was found at 56 ± 8% (40-73) in a shallow-deep direction, and 62 ± 7.0% (40-70) in a high-low direction. The attachment was oriented at 37° to the femoral long axis. The results from this study could be used to guide ACL reconstruction techniques.

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“…knee stability and patient satisfaction (2)(3)(4)(5) . The position of the bone tunnels, and consequently the graft, is considered to be one of the most important factors relating to successful reconstruction (5)(6)(7)(8) . Correct positioning of the bone tunnels is considered to be the most important intraoperative variable, and is directly influenced by the surgeon (9) .…”

Section: Introductionmentioning

confidence: 99%

Análise radiológica do posicionamento dos túneis ósseos na cirurgia de reconstrução do ligamento cruzado anterior: comparação entre as técnicas aberta e artroscópica via portal anteromedial

Dambrós¹,

Florêncio²,

Júnior³

et al. 2011

Rev. bras. ortop.

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Locating femoral graft placement from lateral radiographs in anterior cruciate ligament reconstruction: a comparison of 3 methods of measuring radiographic images

Cited by 48 publications

References 22 publications

Roentgenographic measurement study for locating femoral insertion site of anterior cruciate ligament: a cadaveric study with X-Caliper

Roentgenographic measurement study for locating femoral insertion site of anterior cruciate ligament: a cadaveric study with X-Caliper

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

Análise radiológica do posicionamento dos túneis ósseos na cirurgia de reconstrução do ligamento cruzado anterior: comparação entre as técnicas aberta e artroscópica via portal anteromedial

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