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Tomsan H, Gorbachova T, Fritz RC, Abrams GD, Sherman SL, Shea KG, Boutin RD. Knee MRI: Meniscus Roots, Ramps, Repairs, and Repercussions. Radiographics 2023; 43:e220208. [PMID: 37384542 DOI: 10.1148/rg.220208] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Menisci play an essential role in maintaining normal pain-free function of the knee. While there are decades of MRI literature on the tears involving the meniscus body and horns, there is now a surge in knowledge regarding injuries at the meniscus roots and periphery. The authors briefly highlight new insights into meniscus anatomy and then summarize recent developments in the understanding of meniscus injuries that matter, emphasizing meniscus injuries at the root and peripheral (eg, ramp) regions that may be missed easily at MRI and arthroscopy. Root and ramp tears are important to diagnose because they may be amenable to repair. However, if these tears are left untreated, ongoing pain and accelerated cartilage degeneration may ensue. The posterior roots of the medial and lateral menisci are most commonly affected by injury, and each of these injuries is associated with distinctive clinical profiles, MRI findings, and tear patterns. Specific diagnostic pitfalls can make the roots challenging to evaluate, including MRI artifacts and anatomic variations. As with root tears, MRI interpretation and orthopedic treatment have important differences for injuries at the medial versus lateral meniscus (LM) periphery (located at or near the meniscocapsular junction). Medially, ramp lesions typically occur in the setting of an anterior cruciate ligament rupture and are generally classified into five patterns. Laterally, the meniscocapsular junction may be injured in association with tibial plateau fractures, but disruption of the popliteomeniscal fascicles may also result in a hypermobile LM. Updated knowledge of the meniscus root and ramp tears is crucial in optimizing diagnostic imaging before repair and understanding the clinical repercussions. ©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available in the Online Learning Center.
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Affiliation(s)
- Hanna Tomsan
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Tetyana Gorbachova
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Russell C Fritz
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Geoffrey D Abrams
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Seth L Sherman
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Kevin G Shea
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
| | - Robert D Boutin
- From the Departments of Radiology (H.T., R.D.B.) and Orthopaedic Surgery (G.D.A., S.L.S.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5119; Department of Radiology, Einstein Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa (T.G.); Department of Musculoskeletal Radiology, National Orthopedic Imaging Associates, Greenbrae, Calif (R.C.F.); and Department of Orthopaedic Surgery, Lucile Packard Children's Hospital at Stanford, Palo Alto, Calif (K.G.S.)
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Poutre AJ, Meyers AB. Imaging the pediatric anterior cruciate ligament: not little adults. Pediatr Radiol 2023; 53:1587-1599. [PMID: 36856757 DOI: 10.1007/s00247-023-05608-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 03/02/2023]
Abstract
An increased incidence of anterior cruciate ligament (ACL) injuries in children over the last few decades has led to a corresponding increase in ACL reconstruction procedures in children. In this review, we will illustrate unique features seen when imaging the ACL in children versus adults. After briefly reviewing relevant normal ACL anatomy, we will review imaging findings of congenital ACL dysplasia. This is followed by a discussion of imaging ACL avulsions. Lastly, we will review the different types of ACL reconstruction procedures performed in skeletally immature children and their post-operative appearances.
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Affiliation(s)
- Augustah J Poutre
- Department of Radiology, Brooke Army Medical Center, San Antonio, TX, USA
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 5031, Cincinnati, OH, 45229, USA
| | - Arthur B Meyers
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 5031, Cincinnati, OH, 45229, USA.
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Oshima T, Putnis S, Grasso S, Lim YP, Oshima M, Parker DA. A balance between native footprint coverage and overlap of the anterolateral meniscal root in tibial tunnel positioning during anterior cruciate ligament reconstruction: A 3D MRI study. Knee 2023; 41:106-114. [PMID: 36642034 DOI: 10.1016/j.knee.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 10/13/2022] [Accepted: 12/08/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Tibial footprint of anterior cruciate ligament (ACL) is situated close to the anterior lateral meniscal root (ALMR) attachment. PURPOSE To investigate the impact of the size and location of the tibial tunnel for ACL reconstruction on the ACL footprint coverage and overlap to the ALMR. STUDY DESIGN Controlled laboratory study. METHODS Twenty knee MRI scans from twenty healthy subjects were recruited, and three-dimensional (3D) tibia models were created to show the tibial attachment sites of ACL and ALMR. Surgical simulation of the tibial tunnel drilling was performed on each 3D model, entering the joint at an angle set at 60 degrees from the tibial plateau plane and 55 degrees from the posterior tibial condylar axis, with analysis for six different drill sizes; 7.5, 8, 8.5, 9, 9.5 and 10 mm; and nine locations; the center of the ACL attachment and eight locations 2% of the tibial width apart surrounding it. The width of the tibial plateau, the distance between ACL and ALMR attachment centers, and the size and location of the potential tibial tunnel were evaluated to determine association with the area of the ACL footprint coverage and ALMR overlap using a linear mixed effects model. RESULTS A large tunnel (p <.001), a central and anterior location (p <.029), and small tibial width (p =.015) were all associated with larger coverage of the ACL footprint. A large tunnel (p <.001), posteriorly and laterally located (p ≤ 0.001), and a small distance between the ACL and ALMR centers (p =.001) were significantly associated with a larger ALMR overlap. The association of the tunnel size to ALMR overlap reduced with a medial tunnel location. CONCLUSIONS The short distance between the centers of the ALMR attachment and native ACL footprint suggests that the ALMR will always be susceptible to overlap when the tibial tunnel is drilled in ACL reconstruction. Small alterations in tunnel location can lead to a statistically significant alteration with the amount of ALMR overlap. To minimize this overlap, whilst maintaining acceptable coverage of the ACL footprint, a tibial tunnel positioned in a medial or anteromedial location from the center of the ACL footprint is recommended.
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Affiliation(s)
- Takeshi Oshima
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia; Asanogawa General Hospital, Kanazawa, Ishikawa, Japan
| | - Sven Putnis
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia; Bristol Royal Infirmary, University Hospitals Bristol & Weston NHS Foundation Trust, UK
| | - Samuel Grasso
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - Yoong Ping Lim
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia; The University of Sydney, Sydney, NSW, Australia.
| | - Megumi Oshima
- Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - David Anthony Parker
- Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
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An anatomical study of the meniscal roots of the knee: landmarks for its surgical reconstruction and implications for knee surgeons. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:971-977. [PMID: 35780197 DOI: 10.1007/s00276-022-02979-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/16/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The aim of this anatomical study was to describe the anatomy of the meniscal roots and their relationships with respect to the main adjacent structures in order to improve their surgical reconstruction. METHODS Fourteen knees were included. The mean age of the donors was 92 years (range 89-96). We studied the general characteristics of the anterior and posterior roots of the medial meniscus and lateral meniscus by measuring their widths at their base and area. We investigated the relations between anterior and posterior roots of the medial and lateral menisci with respect to the anterior and posterior cruciate ligaments (ACL and PCL). RESULTS The mean width of the anterior root of the lateral meniscus was 10.5 ± 1.4 mm. The mean width of the anterior root of the medial meniscus was 10 ± 1.5 mm. The mean width of the posterior root of lateral meniscus was 11.4 ± 1.4 mm. The mean width of the posterior root of medial meniscus was 10.5 ± 1.0 mm. The mean distance between the anterior cruciate ligament and the anterior root of lateral meniscus was 9.8 ± 2.9 mm, for the medial meniscus it was 15.9 ± 3.4 mm. The mean distance between the posterior cruciate ligament and the posterior root of the lateral meniscus was 11.5 ± 2.7 mm, for the medial meniscus, it was 11 ± 2.6 mm. CONCLUSION The anterior and posterior meniscal roots have precise landmarks, and this article contributes to define the location of the meniscal roots with respect to their adjacent anatomical structures: ACL, PCL and intercondylar tubercle. Having precise measures of the distances between the meniscus roots and these structures allows knee surgeons to perform ACL reconstruction, meniscal root repair and meniscal allograft transplantation.
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Muro S, Kim J, Tsukada S, Akita K. Significance of the broad non-bony attachments of the anterior cruciate ligament on the tibial side. Sci Rep 2022; 12:6844. [PMID: 35477722 PMCID: PMC9046205 DOI: 10.1038/s41598-022-10806-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/12/2022] [Indexed: 11/09/2022] Open
Abstract
Knowledge of the anatomy of the anterior cruciate ligament (ACL) is important to understand the function and pathology of the knee joint. However, on the tibial side of ACL, its structural relationships with the articular cartilage and lateral meniscus remain unclear. Furthermore, conventional research methods are limited to analyzing the bone attachments. We provide a comprehensive, three-dimensional anatomical description of the tibial side of the ACL that questions the principle that “a ligament is necessarily a structure connecting a bone to another bone.” In our study, 11 knees from 6 cadavers were used for macroscopic anatomical examinations, serial-section histological analyses, and three-dimensional reconstructions. The attachments of the tibial side of ACL consisted of attachments to the bone (102.6 ± 27.5 mm2), articular cartilage (40.9 ± 13.6 mm2), and lateral meniscus (6.5 ± 4.6 mm2), suggesting that the ACL has close structural relationships with the articular cartilage and lateral meniscus. Our study demonstrates that the tibial side of the ACL is not attached to the bone surface only and provides new perspectives on ligamentous attachments. Considering its attachment to the articular cartilage would enable more accurate functional evaluations of the mechanical tensioning of the ACL.
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Affiliation(s)
- Satoru Muro
- Department of Clinical Anatomy, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Jiyoon Kim
- Department of Clinical Anatomy, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Sachiyuki Tsukada
- Department of Clinical Anatomy, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Keiichi Akita
- Department of Clinical Anatomy, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Shao J, Zhang J, Ren S, Liu P, Ma Y, Ao Y. Better Coverage of the ACL Tibial Footprint and Less Injury to the Anterior Root of the Lateral Meniscus Using a Rounded-Rectangular Tibial Tunnel in ACL Reconstruction: A Cadaveric Study. Orthop J Sports Med 2022; 10:23259671221083581. [PMID: 35340730 PMCID: PMC8949746 DOI: 10.1177/23259671221083581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/08/2021] [Indexed: 11/15/2022] Open
Abstract
Background To better restore the anatomy of the native anterior cruciate ligament (ACL) attachment and fiber arrangement, researchers have developed techniques for changing the shape of the ACL bone tunnel during ACL reconstruction. Purpose To compare the coverage of the ACL tibial footprint and influence on the anterior root of lateral meniscus (ARLM) between a rounded-rectangular tibial tunnel and a conventional round tibial tunnel for ACL reconstruction. Study Design Controlled laboratory study. Methods A total of 16 (8 matched-paired) fresh-frozen human cadaveric knees were distributed randomly into 2 groups: a rounded-rectangular tunnel (RRT) group and a round tunnel (RT) group. One of the knees from each pair was reamed with rounded-rectangular tibial tunnel, whereas the other was reamed with round tibial tunnel. Coverage of the ACL tibial footprint and areas of ARLM attachment before and after reaming were measured using 3-dimensional isotropic magnetic resonance imaging. Results In the RRT group, the average percentage of ACL tibial footprint covered by the tunnel was 70.8% ± 2.5%, which was significantly higher than that in the RT group (48.2% ± 6.4%) (P = .012). As for the ARLM attachment area, in the RT group, there was a significant decrease (22.5% ± 5.9%) in ARLM attachment area after tibial tunnel reaming compared with the intact state (P < .001). Conversely, in the RRT group, the ARLM attachment area was not significantly affected by tibial tunnel reaming. Conclusion Rounded-rectangular tibial tunnel was able to better cover the native ACL tibial footprint and significantly lower the risk of iatrogenic injury to the ARLM attachment than round tibial tunnel during ACL reconstruction.
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Affiliation(s)
- Jiayi Shao
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Jiahao Zhang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Shuang Ren
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Ping Liu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Yong Ma
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Yingfang Ao
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China
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Three-Dimensional Reconstruction Algorithm-Based Magnetic Resonance Imaging Evaluation of Biomechanical Changes in Articular Cartilage in Patients after Anterior Cruciate Ligament Reconstruction. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:8256450. [PMID: 35330602 PMCID: PMC8940546 DOI: 10.1155/2022/8256450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the evaluation of biomechanical changes in articular cartilage in patients after anterior cruciate ligament (ACL) reconstruction by magnetic resonance imaging (MRI) based on a three-dimensional (3D) finite element model. The data of 90 patients undergoing arthroscopic ACL reconstruction in the hospital were collected and divided into the stable group (54 cases) and the unstable group (36 cases). A load of up to 134N was applied to the 3D finite element model, and the kinematics of knee flexion at 0°, 30°, 60°, and 90° were examined. The tibial anteversion, tibial rotation, and ACL/graft tension were recorded in the 3D finite element model, which was randomly divided into the normal group (intact group, n = 30), the ACL rupture group (deficient group, n = 30), and the anatomical reconstruction group (anatomical group, n = 30). When the graft was fixed at 0°, the anterior tibial translation at 30°, 60°, and 90° in the anatomic group was 8-19% higher than the normal value under 134 N anterior load. The tibial internal rotation in the anatomic group was 18% and 28% higher than the normal value at 30° and 90°. When the graft was fixed at 30°, the anterior tibial translation at 60° and 90° of the anatomic group was 15% higher than the normal value. The tibial internal rotation at 90° of the anatomic group was 16% higher than the normal value, and the above differences had statistical significance (P < 0.05). MRI images were used to assess the bone tunnel angle, and the statistical analysis by the independent-samples t-test showed that there were significant differences in the bone tunnel angle between the stable group and the unstable group (P < 0.05). Currently, based on the 3D finite element model, MRI can accurately evaluate the postoperative effect of anatomical ACL reconstruction in the position, diameter, and angle of tibial and femoral bone tunnels, which can be applied to clinical promotion.
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Oshima T, Putnis S, Grasso S, Parker DA. The space available for the anterior cruciate ligament in the intercondylar notch is less in patients with ACL injury. Knee Surg Sports Traumatol Arthrosc 2020; 28:2105-2115. [PMID: 32157364 DOI: 10.1007/s00167-020-05921-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/24/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study was to determine if a difference exists in the relationship between the femoral intercondylar notch volume, and the volumes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in ACL injured patients and healthy subjects. METHODS Intact knees of 19 healthy subjects and bilateral knees of 18 ipsilateral ACL reconstructed patients were scanned using 3-tesla high-resolution magnetic resonance imaging. The intercondylar notch, ACL, PCL and hamstring graft were segmented using three-dimensional (3D) processing software. The native intercondylar notch, ACL, and PCL volumes were compared between both groups. The volumes of native ACL and graft were compared in ACL injured patients. RESULTS The following volumes showed no significant differences between the ACL injured group and control group; intercondylar notch (9.9 ± 2.3 vs 9.6 ± 1.7 cm3), ACL (2.4 ± 0.7 vs 2.4 ± 0.6 cm3) and PCL (3.9 ± 1.0 vs 3.4 ± 0.8 cm3), and the ratio of the ACL to the intercondylar notch (24.6 ± 5.0 vs 25.4 ± 2.9%). There was a significant difference in the ratio of PCL to the intercondylar notch (39.1 ± 4.3 vs 35.9 ± 4.9%, p = 0.023). The graft was significantly larger than native ACL volume (3.0 ± 0.7 vs 2.4 ± 0.7 cm3, p = 0.012). CONCLUSIONS The ratio of the PCL volume in the femoral intercondylar notch was higher in the ACL injured group compared to the healthy control group, despite the ratio of ACL volume in the femoral intercondylar notch being similar in both groups. A greater awareness of the potentially limited space for the graft alongside the PCL within the femoral intercondylar notch may allow surgeons a more informed choice of graft type and size. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Takeshi Oshima
- Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, Sydney, NSW, Australia. .,Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Ishikawa, Japan.
| | - Sven Putnis
- Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, Sydney, NSW, Australia.,Avon Orthopaedic Centre, Bristol, UK
| | - Samuel Grasso
- Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, Sydney, NSW, Australia.,The University of Sydney, Sydney, Australia
| | - David Anthony Parker
- Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, Sydney, NSW, Australia.,The University of Sydney, Sydney, Australia
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Oshima T, Grasso S, Beach A, Fritsch B, Parker DA. Lateral location of the tibial tunnel increases lateral meniscal extrusion after anatomical single-bundle anterior cruciate ligament reconstruction. J ISAKOS 2019. [DOI: 10.1136/jisakos-2019-000303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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