2015 ISAKOS Biennial Congress ePoster #1264

Commonly Used ACL Autografts Size are not Correlated with the Size of ACL Footprint and Femoral Condyle

Takanori Iriuchishima, MD, PhD, Takasaki, Gunma JAPAN
Keinosuke Ryu, MD, PhD, Tokyo JAPAN
Shin Aizawa, MD, Tokyo JAPAN
Freddie H. Fu, MD, Pittsburgh, PA UNITED STATES

Nihon University School of Medicine, Tokyo, JAPAN

FDA Status Not Applicable

Summary: There is no correlation between the size of ACL footprint and commonly used autografts. In the ACL reconstruction, if the reconstructed ACL size was determined by the harvested autograft size, there is potential risk of not to be reproduced the native ACL size and anatomy.

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Abstract:

Purpose

The purpose of this study was to reveal the correlation between the size of the native anterior cruciate ligament (ACL) footprint and the size of the commonly used autografts using cadaveric knees.

Methods

Twenty-Four non paired human cadaver knees were used. The ACL was carefully dissected and the periphery of the ACL insertion site was outlined on both the femoral and tibial sides. An accurate lateral view of femoral condyle and the tibial plateau was photographed with a digital camera, and the images were downloaded to a personal computer. The size of the femoral and tibial ACL footprints, length of Blumensaat’s line, and the height and area of the lateral wall of femoral intercondylar notch were measured with Image J software (National Institution of Health). The semitendinosus tendon (ST) and the gracilis (G) tendon were harvested and prepared for ACL grafts. Simulating an ST graft, the ST was cut in half. The bigger half was regarded as the antero-medial (AM) bundle, and the remaining half was regarded as the postero-lateral (PL) bundle. Simulating an ST-G graft, the bigger half of the ST and G were regarded as the AM bundle, and the smaller half of the ST was regarded as the PL bundle. Each graft diameter was measured and the graft area was calculated. Simulating a rectangular bone patella tendon bone (BPTB) graft, a 10mm wide BPTB graft was harvested and the area calculated.

Results

The sizes of the native femoral and tibial ACL footprints were 72.3±24.4, and 134.1±32.4mm2, respectively. The length of Blumensaat’s line, and the height and area of the lateral wall of femoral intercondylar notch were, 29.5±2.5mm, 17.7±2.3mm, and 400.9±62.6mm2, respectively. The average areas of the ST, ST-G, and BPTB graft were 52.7±6.3, 64.7±7.6, and 37.1±7.5mm2. Both the height and the area of the lateral wall of femoral intercondylar notch were significantly correlated with the femoral size of the ACL footprint. However, no significant correlation was observed between ACL footprint size and autografts size. No significant correlation was observed between autografts size and the size of lateral wall of femoral intercondylar notch.

Conclusion

For clinical relevance, there is no correlation between the size of ACL footprint and commonly used autografts. In the ACL reconstruction, if the reconstructed ACL size was determined by the harvested autograft size, there is potential risk of not to be reproduced the native ACL size and anatomy.