Does radiographic location ensure precise anatomic location of the femoral fixation site in medial patellofemoral ligament surgery?
| Autor: | Cristina Ramírez-Fuentes, Erik Montesinos-Berry, Luis Martí-Bonmatí, Vicente Sanchis-Alfonso, Francisco Aparisi-Rodriguez |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Adolescent Radiography Patellar Dislocation Femoral fixation Medial patellofemoral ligament Knee extension Femoral attachment 03 medical and health sciences Patellofemoral Joint Young Adult 0302 clinical medicine Imaging Three-Dimensional Multidetector Computed Tomography Medicine Humans Orthopedics and Sports Medicine Orthopedic Procedures Femur Anatomic Location Fixation (histology) 030222 orthopedics business.industry 030229 sport sciences Middle Aged Surgery medicine.anatomical_structure Orthopedic surgery Chronic Disease Ligaments Articular 3D-CT Female Anatomic reconstruction Anatomic Landmarks business |
| Zdroj: | KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 0942-2056 |
| Popis: | To correlate the location of the medial patellofemoral ligament femoral fixation site in knees suffering a chronic lateral patellar instability, by using radiographic references and by using the most important anatomic reference point (i.e. the adductor tubercle) identified by means of 3-dimensional (3D) surface reconstructions by computed tomography (CT) imaging. Thirty consecutive knee 3D-CT examinations at 0A(0) of knee extension were obtained from patients (20 females, 10 males; median age of 23.5 years; range, 14-48 years) treated for chronic lateral patellar instability with at least two documented patellar dislocations. For each knee, three virtual 7-mm-diameter femoral tunnels were created. One of the tunnels used an anatomic fixation landmark (anatomic fixation), while the other two used established radiologic methods. We calculated the percentage of the anatomic tunnel covered by the tunnel created according to the method described by Schoettle, and the percentage of the anatomic tunnel covered by the tunnel created according to the method described by Stephen. These percentages were compared using paired Student's t test. The percentage of anatomic tunnel area covered by the femoral tunnel created using Schoettle's method was 36.7 +/- 25.2 %. When using Stephen's method, the percentage of overlap with the anatomic femoral tunnel was 25.5 +/- 21.5 %. There were no significant differences between the two radiographic methods (n.s.). None of the standard radiographic methods allowed a precise anatomic femoral placement. Conventional radiographic identification of the femoral graft placement site is only an approximation and should not be the sole basis for femoral attachment location. IV. |
| Databáze: | OpenAIRE |
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