The correlation of femoral tunnel length with the height and area of the lateral wall of the femoral intercondylar notch in anatomical single-bundle ACL reconstruction.

Abstract

The purpose of this study was to reveal the correlation between femoral tunnel length and the height and area of the lateral wall of the femoral intercondylar notch in anatomical single-bundle anterior cruciate ligament (ACL) reconstruction . Twenty-four subjects undergoing anatomical single-bundle ACL reconstruction were included in this study (19 females and 5 males; average age 45.5±16.7). In the anatomical single-bundle ACL reconstruction, the femoral and tibial tunnels were created close to the anteromedial bundle insertion site. Using post-operative three-dimensional computed tomography (3D-CT), an accurate lateral view of the femoral condyle was evaluated. The correlation of femoral tunnel length, which was measured intra-operatively, with the length of Blumensaat's line, and the height and area of the lateral wall of the femoral intercondylar notch was statistically analysed. Tunnel placement was also evaluated using 3D-CT (Quadrant method). The average femoral tunnel length was 35.3±4.9mm. The length of Blumensaat's line, and the height and area of the lateral wall of the femoral intercondylar notch were 33.6±3.4, 22.8±2.4, and 734.6±136mm2, respectively. Both the height and the area of the lateral wall of the femoral intercondylar notch were significantly correlated with femoral tunnel length. Femoral tunnel placement was 24.1±3.9% in a shallow-deep direction, and 33.5±7.7% in a high-low direction. The height and area of the lateral wall of the femoral intercondylar notch are correlated with femoral tunnel length in anatomical single-bundle ACL reconstruction. For clinical relevance, surgeons should be careful not to make the femoral tunnel too short in knees in which the femoral intercondylar notch is low in height or small in size. Case-controlled study, Level III.