The forgotten third: understanding the ACL femoral insertion and lateral intercondylar ridge extension onto the notch roof.

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2025-04-07 DOI:10.1007/s00276-025-03628-6

Leo Gulan, Miljenko Kovačević, Gordana Žauhar, Hari Jurdana, Gordan Gulan

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引用次数: 0

Abstract

Purpose: This study assesses the positioning of the lateral intercondylar ridge (LIR) and the anterior cruciate ligament (ACL) femoral insertion area (FIA) in relation to the femoral notch roof and the lateral notch wall and examines its correlation with the width of the posterior notch outlet.

Method: 45 dried femurs underwent 3D scanning. A cutting plane was established to divide the intercondylar roof from the condylar wall based on three points. The length of the LIR on the roof and wall were measured, along with the distances from key landmarks. The total ACL-FIA and the areas on the roof and wall of the intercondylar notch were measured.

Results: A significant correlation was found between the LIR position on the roof and the width of the notch. LIR averaged 16.18 mm, with 30.86% on the roof, while ACL-FIA averaged 134.19 mm², with 31.55% on the roof. The width of the posterior notch outlet was averaged at 24.34 mm. The distance between the most proximal part of the LIR and the posterior intercondylar line averaged 4.87 mm and 12.46 mm to the most proximal and deepest point of the cartilage border of the lateral femoral condyle.

Conclusion: This study confirms that approximately 30% of the LIR and ACL-FIA extend to the intercondylar notch roof, with a significant moderate positive correlation with the width of the posterior notch outlet. These findings highlight the need to consider the notch roof in the placement of the femoral tunnel for improved anatomical reconstruction of the ACL.

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被遗忘的第三点：了解前交叉韧带股骨止点和外侧髁间脊延伸到切迹顶部。

目的：本研究评估外侧髁间嵴（LIR）和前交叉韧带（ACL）股止点区（FIA）相对于股沟顶和外侧沟壁的位置，并探讨其与后沟出口宽度的相关性。方法：对45根干股骨进行三维扫描。建立了一个切面，以三点为基点将髁间顶与髁壁分开。测量了屋顶和墙壁上LIR的长度，以及与关键地标的距离。测定了总ACL-FIA和髁间切迹顶壁面积。结果：LIR在顶部的位置与切迹的宽度有显著的相关性。LIR平均为16.18 mm，占车顶面积的30.86%，而ACL-FIA平均为134.19 mm²，占车顶面积的31.55%。后切迹出口平均宽度为24.34 mm。LIR最近端至股骨外侧髁软骨边界最近端和最深点距后髁间线平均为4.87 mm和12.46 mm。结论：本研究证实约30%的LIR和ACL-FIA延伸至髁间切迹顶，与后切迹出口宽度有显著的中度正相关。这些发现强调了在股骨隧道放置时考虑缺口顶的必要性，以改善前交叉韧带的解剖重建。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.