Guglielmetti Luiz Gabriel Betoni, de Oliveira Victor Marques, Mestriner Marcos Barbieri, Netto Alfredo Dos Santos, Rabelo Nayra Deise Dos Anjos, Correa Viktor Nelson Mazzola, Aihara Leandro Jun, Cury Ricardo de Paula Leite
Knee Clinic, Department of Orthopaedic and Traumatology, Santa Casa Medical School and Hospitals, São Paulo, Brazil.
Video J Sports Med. 2023 Nov 28;3(6):26350254231201424. doi: 10.1177/26350254231201424. eCollection 2023 Nov-Dec.
Due to the similarity among specimens in the height of the anterior cruciate ligament (ACL) on the distal proximal axis in relation to the proximal posterior cartilage of the lateral femoral condyle (point C), it is known this point can be used as an arthroscopic intraoperative parameter to define the position of the femoral tunnel in ACL reconstruction.
For ACL reconstruction, point C can be used as an arthroscopic intraoperative parameter to define the position of the femoral tunnel on the distal proximal and anteroposterior axes.
For access to the joint, standard arthroscopic ports, both anterolateral (AL) and anteromedial (AM), are used. By directing the camera toward the posterior region of the lateral femoral condyle through the AM port, it is possible to visualize the end of the posterior and proximal articular cartilage, the so-called C point. In this case, we sought to position the center of the femoral tunnel in the center of the AM band of the ACL. Holding the camera through the AM portal and visualizing point C, a millimeter-scale femoral guide is introduced through the AL portal toward the posterior femoral cartilage (point C) and positioned over it, creating a line between point C and the lateral distal femoral cartilage. The distance between point C and the distal femoral cartilage is measured. At this time, an accessory AM portal 1.5 cm from the AM port is constructed. Through it, with the aid of an ice pick or radiofrequency tip, a marking is made in the deep to shallow axis at 35% of this distance. Then, approximately 2 mm above the imaginary line formed by the union of point C and the lateral distal femoral cartilage, the center of the femoral tunnel is marked.
Point C is an anatomical landmark that is easy to view and is present in all knees; thus, it can be used as a reference during surgery for positioning the femoral tunnel.
DISCUSSION/CONCLUSION: Point C can be used as an arthroscopic intraoperative parameter to define the position of the femoral tunnel in ACL reconstruction.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
由于前交叉韧带（ACL）在远侧近端轴向上相对于外侧股骨髁近端后软骨（C点）的高度在标本之间具有相似性，已知该点可作为关节镜手术中确定ACL重建中股骨隧道位置的参数。
对于ACL重建，C点可作为关节镜手术中确定股骨隧道在远侧近端和前后轴上位置的参数。
为进入关节，使用标准的关节镜入路，包括前外侧（AL）和前内侧（AM）入路。通过AM入路将摄像头指向外侧股骨髁的后部区域，可以看到后近端关节软骨的末端，即所谓的C点。在这种情况下，我们试图将股骨隧道的中心定位在ACL的AM束中心。通过AM入路握持摄像头并观察C点，通过AL入路将毫米级股骨导向器引入朝向股骨后软骨（C点）并放置在其上，在C点和外侧股骨远端软骨之间形成一条线。测量C点与股骨远端软骨之间的距离。此时，在距AM入路1.5 cm处构建一个辅助AM入路。通过它，借助冰锥或射频尖端，在该距离的35%处从深到浅轴进行标记。然后，在由C点和外侧股骨远端软骨的连线形成的假想线上方约2 mm处，标记股骨隧道的中心。
C点是一个易于观察且在所有膝关节中都存在的解剖标志；因此，它可在手术期间用作定位股骨隧道的参考。
讨论/结论：C点可作为关节镜手术中确定ACL重建中股骨隧道位置的参数。
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