Three-dimensional reconstruction of the femoral footprint of anterior cruciate ligment by dual-source CT
10.3760/ema.j.issn.1671-7600.2012.01.011
- VernacularTitle:双源三维CT重建前交叉韧带股骨止点的印迹技术
- Author:
Qiang ZHANG
;
Hu XU
;
Yingchun WANG
;
Fangfei SUN
;
Chunli ZHANG
- Publication Type:Journal Article
- Keywords:
Anterior cruciate ligament;
Femur;
Tomography,spiral computed
- From:
Chinese Journal of Orthopaedic Trauma
2012;14(1):40-44
- CountryChina
- Language:Chinese
-
Abstract:
Objective To reconstruct three-dimensional femoral footprint of the anterior cruciate ligament(ACL) by dual-source CT(DSCT),which can provide a novel positioning system particularly applicable in the anatomic ACL reconstruction under arthroscopy. Methods DSCT scanning was performed for the bilateral knees of 30 healthy volunteers.Three-dimensional reconstruction of the lateral wall of the intercondylar notch was done with 64-slice spiral CT workstation(GE,Volume Share2-AW 4.4 version).Double-bundle footprints of the ACL femoral insertions were identified, outlined and marked on the three-dimensional models.The over-the-top junction of the distal femur and the trochlea of femoral lateral condyle was dotted as a reference point O.The femoral footprint long and short axes,the footprint angle between the line passing through 2 centers of anteromedial and posterolateral bundles and the femoral shaft,the distance between 2 bundle centers,the shortest distance from the footprint edge to the distal femoral cartilage,and the shortest distance from the footprint edge to the posterior margin of the femoral cartilage were measured on the models with a standardized scale. Results All the ACL femoral footprints were successfully reconstructed by DSCT in the 60 knee joints.They were relatively protruding,plain,irregular in shape but identical in grey scale,distinct areas on the image. On the three-dimensional models of femoral lateral condyle,a 3-point-2-angle positioning system applicable in arthroscopic anatomic ACL reconstruction was successfully established and used to define and describe the double-bundle insertions of ACL.The mean long and short axes of ACL femoral footprint were respectively 16.5 ± 1.8 mm and 8.0 ± 1.3 mm; the mean ACL footprint angle was 8.3° ±4.9°; the mean distance between 2 bundle centers was 7.8 ± 1.0 mm; the mean shortest distance from the footprint edge to the distal femoral cartilage was 1.6 ± 1.5 mm; the mean shortest distance from the footprint edge to the posterior margin of the femoral cartilage was 1.7 ± 0.9 mm. Conclusions Three-dimensional ACL femoral footprints can be clearly reconstructed with DSCT.Natural ACL femoral footprints vary from person to person,which indicates a need of individualized reconstruction in order to restore the anatomy in maximum.The 3-point-2-angle positioning system we have developed is just suitable for arthroscopic ACL reconstruction.
