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The proximal posterior cartilage of the lateral femoral condyle can be used as a reference for positioning the femoral tunnel in ACL reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To describe the femoral insertion of the ACL using the posterior proximal cartilage of the lateral femoral condyle as the anatomical reference.

Methods

Twenty knees were dissected. The X-axis (deep-shallow) and Y-axis (high-low) were determined using the femoral diaphysis and the proximal cartilage of the lateral femoral condyle (point C) as a reference, which were easily identified by direct visualization through the anteromedial portal. The distances to the center of the anteromedial and posterolateral bands and to the center of the ACL were measured.

Results

The mean distances were 7.2 mm (SD: 0.7) between the center of the anteromedial bundle and the Y-axis (AM-Y), 9 mm (SD: 1.1) between the center of the ACL and the Y-axis (M-Y), and 12.7 mm (SD: 0.9) between the center of the posterolateral bundle and the Y-axis (PL-Y). Regarding the distance (from point C to the distal cartilage along the X-axis), the center of the anteromedial bundle (AM) was 35% (SD: 4.9%), the center of the posterolateral bundle was 62% (SD: 3.7%), and the center of the ACL (M) was 44% (SD: 7%) of the CD distance on average.

Conclusion

Given the similarity among the specimens in terms of the height of the ACL on the Y-axis in relation to the proximal posterior cartilage of the femoral lateral condyle (point C), this point can be used as an arthroscopic intraoperative parameter to define the position of the femoral tunnel in ACL reconstruction for single- or double-bundle techniques.

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Authors and Affiliations

  1. Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Faculdade de Ciências Médicasda Santa Casa de Misericórdiade SãoPaulo, R. Dr. CesárioMotaJúnior, 61, Vila Buarque, SãoPaulo, 01221-020, Brazil

    Ricardo de Paula Leite Cury, Leandro Jun Aihara, Victor Marques de Oliveira & Luiz Gabriel Betoni Guglielmetti

  2. Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil

    Felipe Monteiro Uerlings & Victor Picchi Zaccharias

Authors
  1. Ricardo de Paula Leite Cury
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  2. Leandro Jun Aihara
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  3. Victor Marques de Oliveira
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  4. Felipe Monteiro Uerlings
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  5. Victor Picchi Zaccharias
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  6. Luiz Gabriel Betoni Guglielmetti
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Contributions

LGBG, LJA and RPLC have made substantial contributions to conception and design, FMU and VPZ have made acquisition of data and LGBG, VMO and RPLC have made analysis and interpretation of data. LGBG, LJA have been involved in drafting the manuscript and RPLC and VMO have been involved in revising it critically for important intellectual content. RPLC have given final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Ricardo de Paula Leite Cury.

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Conflict of interest

The authors above declare that they have no conflict of interest.

Ethical approval

The study protocol for obtaining, use and disposal of human tissue specimens received approval, permit number CAAE 08884712.8.0000.5479.

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All patients provided written informed consent prior to participation.

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de Paula Leite Cury, R., Aihara, L.J., de Oliveira, V.M. et al. The proximal posterior cartilage of the lateral femoral condyle can be used as a reference for positioning the femoral tunnel in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 31, 2412–2417 (2023). https://doi.org/10.1007/s00167-022-07168-z

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  • DOI: https://doi.org/10.1007/s00167-022-07168-z

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