The posterior femoral cartilage can be used as an anatomical reference for the creation of the femoral tunnel in anterior cruciate ligament reconstruction.

Corrêa, Viktor Nelson Mazzola; Dos Anjos Rabelo, Nayra Deise; Dos Santos Netto, Alfredo; de Oliveira, Victor Marques; Guglielmetti, Luiz Gabriel Betni; de Paula Leite Cury, Ricardo · J Exp Orthop · 2025

case_series · Level IV

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Abstract

The objective of the study was to evaluate the accuracy of femoral tunnel positioning in the reconstruction of the anteromedial (AM) bundle of the Anterior Cruciate Ligament (ACL) using the most proximal and posterior portion of the lateral femoral condyle cartilage (Point C). From December 2022 to December 2023, 47 patients underwent anterior cruciate ligament reconstruction (ACLR) in outside in manner using Point C as an anatomical landmark for AM bundle ACLR. After the procedure, the patients underwent tomographic evaluation to assess the accuracy of the positioning, using Bernard's quadrants. Two evaluators at three different times measured the percentages for each case. The average distance from Point C to the anterior portion of the lateral femoral condyle was 23.3 mm, and the average correlation value of Point C with the centre of the AM bundle in the horizontal coordinate intraoperatively was 7.7 mm. The average depth values (X coordinate) for evaluator 1 at Time 1 were 23.6%, and at Time 2 were 23.6%. The average height values (Y coordinate) at Time 1 were 22.7%, and at Time 2 were 22.1%. The analysis by the second evaluator at the third time point had an average X coordinate of 23.6% and Y coordinate of 22.3%. Point C proved to be a reliable anatomical landmark, exhibiting good accuracy in mimicking the AM bundle in the femoral tunnel during ACLR. Level IV.