Abstract
ABSTRACTObjective: To compare the transparent 3D computed tomography (CT) image protocol against conventional 3D-CT image-rendering protocol to assess femoral tunnel position in anatomic anterior cruciate ligament (ACL) reconstructions. Methods: Eight knee CT scans from cadavers were analyzed by image rendering 3D-CT protocol, using Rhinoceros(r) software. The central point of the ACL tunnel was set using the sagittal plane. Same CT scans were analyzed using transparent 3D-CT measurement protocol with OsiriX(r) software. Central point of the ACL tunnel was set using sagittal, coronal and axial planes. The grid system described by Bernard and Hertel was used to compare tunnel positions between protocols, using height and length parameters. Results: There was a significant difference between measurements using image rendering 3D-CT and transparent 3D-CT protocol for height (23.8 ± 7.9mm and 33.0 ± 5.0mm, respectively; p=0.017) and no differences for length (18.6 ± 4.2mm and 18.3 ± 4.5mm, respectively; p=0.560). Conclusion: Height in transparent CT protocol was different and length was the same as compared to 3D-CT rendering protocol in Bernard and Hertel method for tunnel measurements. Level of Evidence II, Descriptive Laboratory Study.
Highlights
Recent research on anterior cruciate ligament (ACL) reconstruction has endorsed restoration of the original anatomy.[1,2] Correct placement of the femoral and tibial tunnels may help restore physiological relationships and ensure near-normal function of the knee joint
We evaluated 8 unilateral knee computed tomography (CT) scans of cadavers, with the approval of the University of São Paulo Medical School Institutional Review Board (CEP no 436/11)
Z -x y stability closer to the native ACL and provides better knee kinematics when compared to non-anatomical ACL reconstruction.[19]
Summary
Recent research on anterior cruciate ligament (ACL) reconstruction has endorsed restoration of the original anatomy.[1,2] Correct placement of the femoral and tibial tunnels may help restore physiological relationships and ensure near-normal function of the knee joint. The quadrant method, originally described by Bernard et al.,[4] is the most commonly used reference for location of the ACL, originally described for the lateral x-ray of the distal femur.[5,6,7] Gold standard imaging technique for evaluating osseous anatomy of the knee and anatomical femoral tunnel position is the rendering 3D computed tomography (CT) scan.[8,9,10,11,12,13,14,15] conventional 3D CT rendering is time consuming and technically demanding. A less demanding open-source 3D CT protocol based on the principles of Bernard and Hertel x-ray method has recently been introduced and suggested for ACL femoral tunnel measurement.[16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
