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.
Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil.
Knee Surg Sports Traumatol Arthrosc. 2023 Jun;31(6):2412-2417. doi: 10.1007/s00167-022-07168-z. Epub 2022 Oct 8.
To describe the femoral insertion of the ACL using the posterior proximal cartilage of the lateral femoral condyle as the anatomical reference.
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.
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.
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.
以股骨外髁近端后软骨为解剖学参考,描述 ACL 的股骨附着点。
对 20 个膝关节进行解剖。X 轴(深-浅)和 Y 轴(高-低)使用股骨骨干和股骨外髁近端软骨(点 C)作为参考确定,通过前内侧入路直接可视化很容易识别。测量前内束和后外束中心以及 ACL 中心到该参考点的距离。
前内束中心到 Y 轴(AM-Y)的平均距离为 7.2mm(SD:0.7),ACL 中心到 Y 轴(M-Y)的距离为 9mm(SD:1.1),后外束中心到 Y 轴(PL-Y)的距离为 12.7mm(SD:0.9)。关于(沿着 X 轴从点 C 到远端软骨的距离),前内束(AM)中心为 35%(SD:4.9%),后外束中心为 62%(SD:3.7%),ACL(M)中心为 CD 距离的 44%(SD:7%)。
鉴于标本在 Y 轴上 ACL 高度与股骨外髁近端后软骨(点 C)之间的相似性,该点可作为关节镜手术中用于定义 ACL 重建中单束或双束技术中股骨隧道位置的参数。