Morphology of the Femoral Intercondylar Notch

Farrow, Lutul D.; Chen, Michael R.; Cooperman, Daniel R.; Victoroff, Brian N.; Goodfellow, Donald B.

doi:10.2106/jbjs.f.01191

Cited by 51 publications

(45 citation statements)

References 16 publications

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“…Due to these suboptimal results, there is a paradigm shift ongoing from the “transtibial” towards the “anatomic” ACL reconstruction technique (Yasuda et al 2004; Mae et al 2010; van Eck et al 2010; Chechik et al 2013). The “anatomic” ACL reconstruction aims to place the graft at the native insertion sites by relying on arthroscopically visualizing anatomical landmarks such as the posterior wall, cartilage edge, the lateral intercondylar ridge, and bifurcate ridge to locate the native insertion sites (Yasuda et al 2004; Farrow et al 2007; Ferretti et al 2007; Mae et al 2010; van Eck et al 2010; Ziegler et al 2011). This method, though is time consuming and demanding due to the visual limitations with the current white light endoscopic systems, careful dissection, biological variability, and additional visual impairment in the injured and degenerated joint.…”

Section: Discussionmentioning

confidence: 99%

Autofluorescence imaging for improved visualization of joint structures during arthroscopic surgery

et al. 2017

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BackgroundThe purpose of our study is to develop the arthroscopic autofluorescence imaging (AFI) system to improve the visualization during arthroscopic surgery by real-time enhancing the contrast between joint structures with autofluorescence imaging. Its validity was evaluated around the arthroscopic anterior cruciate ligament (ACL) reconstruction, specifically improving the contrast between the femoral insertion site and its background. The feasibility of the AFI system was validated with bovine and human knees. The spectral responses of the femoral insertion site and its surrounding bone and cartilage were measured with a fluorospectrometer. A prototype of the AFI system was developed based on the spectral responses (SR) and test images of the insertion site. The accuracy was validated by evaluating the overlap between manually segmented insertion sites on the white light color images and on the corresponding spectral unmixed autofluorescence images. The final prototype of the AFI system was tested during arthroscopy in cadaveric knees.ResultsThe results showed that the joint structures have different SRs. Spectral unmixing enabled separation of the SRs and improved the contrast between the joint structures. The agreement between visible light and autofluorescence ligament insertions had a mean Dice coefficient of 0.84 and the mean Dice coefficient of the interobserver variability for visible light imaging was 0.85.ConclusionsWe have shown that the femoral insertion site can be accurately visualized with autofluorescence imaging combined with spectral unmixing. The AFI system demonstrates the feasibility of real-time and subject-specific visualization of the femoral insertion site which can facilitate anatomic ACL reconstruction. In addition, the AFI system can facilitate arthroscopic procedures in other joints and can also be used as a diagnostic tool.Electronic supplementary materialThe online version of this article (doi:10.1186/s40634-017-0094-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Autofluorescence imaging for improved visualization of joint structures during arthroscopic surgery

et al. 2017

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“…In the coronal plane, the common goal is to place the tunnel between the 1 and 2 o'clock position on the left and between 10 and 11 o'clock position on the right [4]. Tunnel placement based on lateral intercondylar ridge and lateral bifurcate ridge, is a more reliable approach [5][6][7][8]. The lateral intercondylar ridge is the superior border of the ACL with the knee in 90 o of flexion, and the anterior border of the ACL with the knee in full extension [6,7].…”

Section: Discussionmentioning

confidence: 99%

Femoral notch cleaning in anterior cruciate ligament reconstruction: a new instrument

Milankov¹,

Miljković²,

Gojković³

2010

JBiSE

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This article describes using of this new, improvised instrument that enables better removal of ACL remnants, increased visibility of the intercondylar notch, precise location of the femoral tunnel and by doing this shor- tens the operative time. Also, the use of this instrument is cost beneficial, because it decreases the number of disposable shaver tips used and can decrease the cost of the procedure which is important for countries with poor economies

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“…A factor that potentially influences the ability of reconstruction to restore normal knee biomechanics is placement of the ACL graft . In particular, previous work suggests that non‐anatomic placement of the graft on the femur may be a common problem in ACL reconstruction .…”

Section: In Vivo Measurement Of Acl Graft Placement On the Femurmentioning

confidence: 99%

Effects of ACL graft placement on in vivo knee function and cartilage thickness distributions

DeFrate

2017

J. Orthop. Res.

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Injuries to the anterior cruciate ligament (ACL) frequently lead to early-onset osteoarthritis. Despite advancement in surgical techniques, ACL reconstruction has a limited ability to prevent these degenerative changes. While previous studies have investigated knee function after ACL reconstruction, in vivo investigations of the effects of graft placement on in vivo joint function and cartilage health are limited. This review presents a series of studies that used novel imaging and 3D modeling techniques to determine the in vivo placement of the ACL graft on the femur using two different ACL reconstruction techniques. These techniques resulted in two distinct graft placement groups: one where the ACL was placed anatomically near the center of the native ACL footprint and another where the graft was placed anteroproximally on the femur, centered outside the ACL footprint. We quantified the effects of graft placement on graft deformation during in vivo loading and how these variables affected knee motion. Finally, we quantified whether femoral placement of the graft affected cartilage thickness. Our results demonstrate that achieving anatomic graft placement on the femur is critical to restoring native ACL function and normal knee kinematics. Knees with grafts that more closely restored normal ACL function, and thus knee motion, experienced less focal cartilage thinning than did those that experienced abnormal knee motion. These results suggest that achieving anatomic graft placement is a critical factor in restoring normal knee motion and potentially slowing the development of degenerative changes after ACL reconstruction.

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Morphology of the Femoral Intercondylar Notch

Abstract: The morphology of the femoral intercondylar notch varies little. Occasionally, the posterolateral rim of the intercondylar notch is not well-defined. In these knees, accurate placement of commercial femoral tunnel aiming guides may be difficult.

Cited by 51 publications

References 16 publications

Autofluorescence imaging for improved visualization of joint structures during arthroscopic surgery

Autofluorescence imaging for improved visualization of joint structures during arthroscopic surgery

Femoral notch cleaning in anterior cruciate ligament reconstruction: a new instrument

Effects of ACL graft placement on in vivo knee function and cartilage thickness distributions

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