Pattern of Angular Change of the Anterior Cruciate Ligament Across the Range of Knee Flexion and the Related Anatomical Dimensions
Tanvaa Tansatit MD*, Suriyapong Saowaprut MD**, Wicharn Kanchanatawan MD**, Thanisara Chomkerd MSc***
Affiliation : * Department of Anatomy, Faculty of Medicine, Chulalongkorn University ** Institute of Orthopedics, Leardsin General Hospital *** Master of Science in Anatomy, Faculty of Medicine, Chulalongkorn University
Improper femoral and/or tibial tunnel placements are major causes of failure in anterior cruciate ligament (ACL) reconstruction. The 52 embalmed cadaveric knees were measured the dimensions of the surgical related structures using vernier caliper and goniometer. The intercondylar notch width was 17.4 ± 2.3 mm and slope of the roof was 31.3 ± 3.4 degrees. The average length of ACL was 21.6 ± 2.5 mm. The relation of tibial attachment was 47.98 % of the width of the lateral tibial plateau and 49.8 % anteriorly, when it was measured through ACL attachment. Angle of ACL in sagittal plane was decreased during knee flexion. On the contrary, angle of ACL in coronal plane was increased during knee flexion. According to this study, The expected femoral tunnel at 10.00 am to 10.30 am could be performed by arthroscopic transtibial technique using the 48% of tibial width anteriorly for intraartricular tibial-tunnel drill-guide placement and aiming for sagittal and coronal plane of 52.0 ± 4.6 / 20.9 ± 3.9 , 46.2 ± 5.1 / 26.8 ± 4.6 degrees, and 41.6 ± 5.1 / 32.0 ± 4.3 degrees while knee flexion degree were as 60, 90, and 120 degrees , respectively.
Keywords : Anterior cruciate ligament, Tibial tunnel, Femoral tunnel, Transtibial technique
