Suruga Makoto, Horaguchi Takashi, Iriuchishima Takanori, Iwama Genki, Yahagi Yoshiyuki, Tokuhashi Yasuaki, Aizawa Shin
Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-0032, Japan.
Department of Orthopaedic Surgery, Nihon University Hospital, Tokyo, Japan.
Eur J Orthop Surg Traumatol. 2019 May;29(4):849-854. doi: 10.1007/s00590-019-02387-6. Epub 2019 Jan 31.
"Anatomical" anterior cruciate ligament (ACL) reconstruction is defined as the functional restoration of the ACL to its native dimensions. It is essential to obtain more accurate predictors of ACL size before surgery. The purpose of this study was to investigate the correlation between the native femoral ACL footprint size and the morphology of the distal femur using three-dimensional CT (3D-CT).
Thirty non-paired Japanese human cadaver knees were used. All soft tissues around the knee were resected except the ACL. For the evaluation of femoral condyle morphology, trans-epicondylar length (TEL), notch outlet length, axial notch area, and notch width index were measured using 3D-CT. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch. The ACL was carefully dissected, and the boundaries of the ACL insertion site were outlined on the femoral side. An accurate lateral view of the femoral condyle was photographed with a digital camera. The size of the femoral ACL footprint, length of Blumensaat's line, and the height and area of the lateral wall of the femoral intercondylar notch were measured with ImageJ software.
Notch height, lateral notch area, and TEL were significantly correlated with the femoral ACL footprint area. Both axial notch area and notch outlet length were significantly correlated with the femoral mid-substance insertion area.
Morphological evaluation using 3D-CT preoperatively may be useful in predicting the femoral ACL footprint size.
“解剖学”前交叉韧带（ACL）重建被定义为将ACL功能恢复至其原始尺寸。术前获得更准确的ACL尺寸预测指标至关重要。本研究的目的是使用三维CT（3D-CT）研究股骨ACL原始足迹大小与股骨远端形态之间的相关性。
使用30个非配对的日本人体尸体膝关节。除ACL外，切除膝关节周围的所有软组织。为评估股骨髁形态，使用3D-CT测量经髁间长度（TEL）、髁间切迹出口长度、轴向髁间切迹面积和髁间切迹宽度指数。在ACL中间切断，并在股骨切迹最近端处切断股骨。小心解剖ACL，并在股骨侧勾勒出ACL插入部位的边界。用数码相机拍摄股骨髁的精确侧视图。使用ImageJ软件测量股骨ACL足迹大小、布卢门萨特线长度以及股骨髁间切迹外侧壁的高度和面积。
髁间切迹高度、外侧髁间切迹面积和TEL与股骨ACL足迹面积显著相关。轴向髁间切迹面积和髁间切迹出口长度均与股骨中部插入面积显著相关。
术前使用3D-CT进行形态学评估可能有助于预测股骨ACL足迹大小。
