2015 ISAKOS Biennial Congress ePoster #1225

The Evaluation of the Lateral Intercondylar Ridge by Three-Dimensional Computed Tomography in the Bilateral Knee Before ACL Reconstruction

Daisuke Hatsushika, MD, PhD, Kawaguchi, Saitama JAPAN
Msaki Otsuji, MD, Kawaguchi, Saitama JAPAN
Masaya Hayashi, MD, PhD, Kawaguchi, Saitama JAPAN
Masayuki Shimaya, MD, PhD, Kawaguchi, Saitama JAPAN
Mai Katakura, MD, Kisarazu, Chiba JAPAN
Mari Uomizu, MD, Bunkyo Ku, Tokyo JAPAN
Hideya Yoshimura, MD, PhD, Kawaguchi, Saitama JAPAN
Takashi Ogiuchi, MD, Kawaguchi, Saitama JAPAN

Kawaguchi Kogyo General Hospital, Kawaguchi, Saitama, JAPAN

FDA Status Cleared

Summary: Three knee specialists quantified the identifiability of lateral intercondylar ridges. The lateral intercondylar ridges in the normal knee were identified more easily than in the ACL injured knee. Identification of the regident’s ridges in the knee with chronic ACL insufficiency could be more difficult than in the fresh ACL injured knee.

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Abstract:

Introduction

The anterior cruciate ligament (ACL) attaches to the posterior-superior border of the intercondylar notch of the femur. The lateral intercondylar ridge (LIR) has been recognized as an important landmark to create the femoral tunnel in ACL reconstruction. However, sometimes identifying the LIR is not easy.

Purpose

The purposes of this study are to evaluate the identifiability of the LIR, to make a comparison between the injured knee and the contralateral knee in ACL injured patients, and to investigate whether the age, the sex, the difference of the value in KT-1000, and the duration from the ACL injury influence to the identification of the LIR.

Methods

Consecutive 140 patients undergoing primary ACL reconstruction at one institution were participated in this retrospective review. They consisted of 74 males and 66 females with a mean age of 23 years ranging from 13 to 46 years. Patients with the bilateral ACL injury were excluded. The lateral intercondylar areas were examined with three-dimensional computed tomography (3-D CT) in bilateral knee. A total of 280 images of the LIR by 3D-CT were made. To quantify the identifiability of the LIR, the scoring was performed as follows by the 3 well-trained knee surgeons. The 3D-CT images of the LIR, which could be identified easily, were categorized into 2 points, which could be identified but not easily, were categorized into 1 point, and which could not be identified, were categorized into 0 point. Then the total score (0~6) was used for comparison. Furthermore the patients were grouped as follows. Group N>I: The score of the normal knee was larger than that of the ACL injured knee. Group I>=N: The score of the ACL injured knee was larger than that of the normal knee, or equivalent to the normal knee. The comparison of the score between the two groups was performed with age, sex, the side-to-side difference of the value in KT-1000, and the duration from the ACL injury to 3-D CT imaging.

Results

The score of the normal knee was significantly larger than that of ACL injured knee (p<0.01). Moreover, although no significant differences between Group N>I and Group I>=N were shown in the age, the sex, and the side-to-side difference of the value in KT-1000, the score of Group N>I was significantly larger than that Group I>=N in the duration from the ACL injury to 3-D CT imaging (p<0.05).

Conclusion

Three well-trained knee surgeons evaluated the identifiability of the LIR. The LIR in the normal knee were identified more easily than in the ACL injured knee. Identification of the LIR in the knee with chronic ACL insufficiency could be more difficult than in the fresh ACL injured knee.