Correlation between Femoral Tunnel Location in Three-Dimensional Computed Tomography and Femoral Tunnel Angle in Plain Radiographs after Single-Bundle Anterior Cruciate Reconstruction

Ju-Hong Lee; Hyuk Park; Seong-Yup Jeong

doi:10.4055/jkoa.2014.49.1.43

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Lee, Park, and Jeong: Correlation between Femoral Tunnel Location in Three-Dimensional Computed Tomography and Femoral Tunnel Angle in Plain Radiographs after Single-Bundle Anterior Cruciate Reconstruction

Original Article

Journal of the Korean Orthopaedic Association 2014; 49(1): 43-49.

Published online: 27 February 2014

DOI: https://doi.org/10.4055/jkoa.2014.49.1.43

Correlation between Femoral Tunnel Location in Three-Dimensional Computed Tomography and Femoral Tunnel Angle in Plain Radiographs after Single-Bundle Anterior Cruciate Reconstruction

Ju-Hong Lee, M.D., Hyuk Park, M.D., Seong-Yup Jeong, M.D.

Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.

Correspondence to: Hyuk Park, M.D. Department of Orthopedic Surgery, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 561-712, Korea. TEL: +82-63-250-1760, FAX: +82-63-271-6538, hyukpark@jbnu.ac.kr

Received 18 June 2013 Revised 15 October 2013 Accepted 23 December 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to determine correlation between femoral tunnel angle in the coronal plane on a simple radiograph and femoral tunnel location in the sagittal plane on three-dimensional computed tomography (3D-CT).

Materials and Methods

The subjects included 42 patients who underwent 3D-CT after the operation out of 70 cases of anterior cruciate ligament reconstruction using quadriceps tendon-patelllar bone autograft from April, 2009 to June, 2011. Measurement of the femoral tunnel angle was based on the anatomical axis of the femur in antero-posterior (AP) and Rosenberg views; femoral tunnel location was described as a proportional percentage on the medial surface of the lateral femoral condyle in the 3D-CT image; then the correlation between femoral tunnel angle and femoral tunnel location was analyzed retrospectively.

Results

Femoral tunnel angle was 41.5°±6.8° (range: 29.7°-53.9°) on AP radiographs, and 34.9°±6.9° (range: 23.8°-46.5°) on Rosenberg views. The femoral tunnel was located 36.9%±11.3% from posterior, and 38.1%±6.5% from proximal on the 3D-CT image. On plain AP radiographs, femoral tunnel angle and femoral tunnel location showed negative correlation (p<0.001, rho=-0.498), and, in comparison with Rosenberg view, they showed negative correlation (p=0.006, rho=-0.416). Twenty three patients (53.5%) had femoral tunnel in the anatomical location. Their femoral tunnel angle on AP radiographs was 43.3°±6.1°, while the femoral tunnel angle of patients who had femoral tunnel in non-anatomical locations was 38.4°±6.4° (p=0.004). In the Rosenberg picture, similar difference was observed between the two groups (p=0.012).

Conclusion

On AP radiographs and Rosenberg views, femoral tunnel angle showed significant correlation with the femoral tunnel location on the 3D-CT image, and the group who had femoral tunnel location in the anatomical range showed a relatively higher femoral tunnel angle.

Keywords: anterior cruciate ligament reconstruction, femoral tunnel angle, femoral tunnel location, three-dimensional computed tomography

Figures and Tables

Figure 1

The femoral tunnel angle (^*) is measured from the longitudinal axis of the femoral tunnel (x) and anatomical axis (y) of the femur on antero-posterior (A) and Rosenberg views (B).

Figure 2

Femoral tunnel location was described as a proportional percentage (from proximal to distal and posterior to anterior) on the medial surface of the lateral femoral condyle in the three-dimensional computed tomography image. The circle showed position of the graft in femoral tunnel.

Table 1

Patient Information

Values are presented as number or median (range).

Table 2

Relation between CT Position and Femoral Tunnel Angle on X-ray

CT, computed tomography; FTA, femoral tunnel angle; AP, antero-posterior; PA, posterior to anterior; PD, posterior to distal.

Table 3

Femoral Tunnel Position on Three-Dimensional CT

Values are presented as mean±standard deviation. CT, computed tomography; PA, posterior to anterior; PD, posterior to distal; FTA, femoral tunnel angle; AP, antero-posterior.

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