Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical Study
During knee arthroscopy, easy orientation is important, and possible landmarks include the lateral intercondylar ridge (LIR) and the lateral bifurcate ridge (LBR). The objective was to show the feasibility of the LIR and the LBR as landmarks of the femoral attachment of the anterior cruciate ligamen...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-06-01
|
| Series: | Applied Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3417/13/12/7345 |
| _version_ | 1827738681242288128 |
|---|---|
| author | Lena Hirtler Dominik Rieschl Sam A. Kandathil Patrick Weninger |
| author_facet | Lena Hirtler Dominik Rieschl Sam A. Kandathil Patrick Weninger |
| author_sort | Lena Hirtler |
| collection | DOAJ |
| description | During knee arthroscopy, easy orientation is important, and possible landmarks include the lateral intercondylar ridge (LIR) and the lateral bifurcate ridge (LBR). The objective was to show the feasibility of the LIR and the LBR as landmarks of the femoral attachment of the anterior cruciate ligament (ACL) among subjects with different levels of training. Thirty-six formalin-phenol-fixed lower extremities were acquired for this prospective macroscopic anatomical study. All soft tissue apart from the ligaments was removed. The two bundles of the ACL and their origins were identified, marked and photographed. Photographs were taken in an arthroscopic setting. An orthopedic surgeon, an anatomist and a medical student identified the ridges. The LIR existed in 80.6% of samples, while the LBR existed in 13.8% of samples. A significant difference existed between the raters in correctly identifying the LIR (<i>p</i> < 0.01). Due to its high frequency, the LIR seems more reliable than the LBR, especially as the LBR has the potential for false positive identification. Nevertheless, as these ridges are not easily discernible, the surgeon has to know the anatomy of the intercondylar notch perfectly to stand even a small chance of correctly placing drill holes in ACL reconstruction. New guidelines for more easily recognizing LIR and LBR arthroscopically are proposed. |
| first_indexed | 2024-03-11T02:47:45Z |
| format | Article |
| id | doaj.art-73c70fb3cce4440e883c97dec470f9cd |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-11T02:47:45Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-73c70fb3cce4440e883c97dec470f9cd2023-11-18T09:12:33ZengMDPI AGApplied Sciences2076-34172023-06-011312734510.3390/app13127345Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical StudyLena Hirtler0Dominik Rieschl1Sam A. Kandathil2Patrick Weninger3Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, 1090 Vienna, AustriaAlfried Krupp Hospital Essen, 45131 Essen, GermanyDivision of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, 1090 Vienna, AustriaKnie & Sport, 1010 Vienna, AustriaDuring knee arthroscopy, easy orientation is important, and possible landmarks include the lateral intercondylar ridge (LIR) and the lateral bifurcate ridge (LBR). The objective was to show the feasibility of the LIR and the LBR as landmarks of the femoral attachment of the anterior cruciate ligament (ACL) among subjects with different levels of training. Thirty-six formalin-phenol-fixed lower extremities were acquired for this prospective macroscopic anatomical study. All soft tissue apart from the ligaments was removed. The two bundles of the ACL and their origins were identified, marked and photographed. Photographs were taken in an arthroscopic setting. An orthopedic surgeon, an anatomist and a medical student identified the ridges. The LIR existed in 80.6% of samples, while the LBR existed in 13.8% of samples. A significant difference existed between the raters in correctly identifying the LIR (<i>p</i> < 0.01). Due to its high frequency, the LIR seems more reliable than the LBR, especially as the LBR has the potential for false positive identification. Nevertheless, as these ridges are not easily discernible, the surgeon has to know the anatomy of the intercondylar notch perfectly to stand even a small chance of correctly placing drill holes in ACL reconstruction. New guidelines for more easily recognizing LIR and LBR arthroscopically are proposed.https://www.mdpi.com/2076-3417/13/12/7345anterior cruciate ligamentACLlateral intercondylar ridgelateral bifurcate ridgeosseous landmark |
| spellingShingle | Lena Hirtler Dominik Rieschl Sam A. Kandathil Patrick Weninger Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical Study Applied Sciences anterior cruciate ligament ACL lateral intercondylar ridge lateral bifurcate ridge osseous landmark |
| title | Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical Study |
| title_full | Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical Study |
| title_fullStr | Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical Study |
| title_full_unstemmed | Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical Study |
| title_short | Feasibility of Osseous Landmarks for ACL Reconstruction—A Macroscopic Anatomical Study |
| title_sort | feasibility of osseous landmarks for acl reconstruction a macroscopic anatomical study |
| topic | anterior cruciate ligament ACL lateral intercondylar ridge lateral bifurcate ridge osseous landmark |
| url | https://www.mdpi.com/2076-3417/13/12/7345 |
| work_keys_str_mv | AT lenahirtler feasibilityofosseouslandmarksforaclreconstructionamacroscopicanatomicalstudy AT dominikrieschl feasibilityofosseouslandmarksforaclreconstructionamacroscopicanatomicalstudy AT samakandathil feasibilityofosseouslandmarksforaclreconstructionamacroscopicanatomicalstudy AT patrickweninger feasibilityofosseouslandmarksforaclreconstructionamacroscopicanatomicalstudy |