Westermann Robert, Sybrowsky Christian, Ramme Austin, Amedola Annuziati, Wolf Brian R
Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa.
Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa.
J Knee Surg. 2014 Feb;27(1):53-8. doi: 10.1055/s-0033-1348409. Epub 2013 Jun 13.
There is increasing use of three-dimensional (3D) computed tomography (CT) for researching anterior cruciate ligament (ACL) reconstructions and tunnel placement. However, there is limited 3D CT data on the ACL footprint. The purpose of this study is to define the native ACL femoral footprint using 3D surface reconstructions of computed tomography (CT) imaging of cadaveric knees. The femoral insertion of the ACL was meticulously dissected and marked with drill holes in seven cadaveric knees. CT scans were performed on each specimen, and 3D computer models were created. Distance from the condyle edges to the margins of the footprint were referenced to the total condylar size. This was performed both parallel and perpendicular to the femoral axis as well as the intercondylar notch. The mean condylar depth (c/C) ratios along the axis of the femur were 0.45 ± 0.06 for the anterior border, 0.44 ± 0.08 for the posterior border, 0.26 ± 0.07 for the proximal border, and 0.63 ± 0.08 for the distal border. The mean notch (n/N) ratios for the four margins were 0.37 ± 0.04 for the anterior border, 0.67 ± 0.08 for the posterior border, 0.49 ± 0.07 for the proximal margin, and 0.50 ± 0.06 for the distal border. The mean c/C ratios parallel the intercondylar notch measured 0.23 ± 0.03 for the anterior border, 0.27 ± 0.04 for the posterior border, 0.37 ± 0.04 for the proximal border, and 0.12 ± 0.02 for the distal border. The mean n/N ratios perpendicular to the intercondylar notch measured 0.11 ± 0.06 for the anterior border, 0.52 ± 0.09 the posterior border, 0.29 ± 0.06 for the proximal border, and 0.30 ± 0.06 for the distal border. This study provides reference measures of the femoral footprint of the ACL using 3D CT. It will assist future studies that use advanced imaging to evaluate accuracy of ACL reconstruction.
三维（3D）计算机断层扫描（CT）在研究前交叉韧带（ACL）重建和隧道放置方面的应用越来越广泛。然而，关于ACL足迹的3D CT数据有限。本研究的目的是利用尸体膝关节CT成像的3D表面重建来定义天然ACL股骨足迹。在七个尸体膝关节中，对ACL的股骨附着点进行了细致解剖并用钻孔标记。对每个标本进行CT扫描，并创建3D计算机模型。从髁边缘到足迹边缘的距离以髁的总尺寸为参照。分别在平行和垂直于股骨轴线以及髁间切迹的方向上进行测量。沿股骨轴线的平均髁深度（c/C）比值，前边界为0.45±0.06，后边界为0.44±0.08，近端边界为0.26±0.07，远端边界为0.63±0.08。四个边缘的平均切迹（n/N）比值，前边界为0.37±0.04，后边界为0.67±0.08，近端边缘为0.49±0.07，远端边界为0.50±0.06。平行于髁间切迹测量的平均c/C比值，前边界为0.23±0.03，后边界为0.27±0.04，近端边界为0.37±0.04，远端边界为0.12±0.02。垂直于髁间切迹测量的平均n/N比值，前边界为0.11±0.06，后边界为0.52±0.09，近端边界为0.29±0.06，远端边界为0.30±0.06。本研究提供了使用3D CT测量的ACL股骨足迹的参考数据。这将有助于未来利用先进成像技术评估ACL重建准确性的研究。
