Intact PCL is a potential predictor of ACL graft size in the skeletally immature knee and other anatomic considerations for ACL reconstruction

Journal of Experimental Orthopaedics

Grant D. Hogue¹  Alexander V. Nguyen²  Samuel S. Ornell³  David M. Heath³  Travis S. Bullock³  Katherine C. Bartush³ 

[1] Department of Orthopaedics, Boston Children’s Hospital/Harvard Medical School, 300 Longwood Avenue, 02115, Boston, MA, USA;Department of Orthopaedics, Lenox Hill Hospital, 10075, New York, NY, USA;Department of Orthopaedics, UT Health San Antonio, 78249, San Antonio, TX, USA;

关键词: Pediatric;    Knee;    Anterior cruciate ligament;    ACL;    Posterior cruciate ligament;    PCL;    Arthroscopy;    Magnetic resonance imaging;    MRI;    ACL reconstruction;   

DOI  :  10.1186/s40634-021-00437-9

来源: Springer

【 摘 要 】

PurposeTo develop a method for using an intact posterior cruciate ligament (PCL) as a predictor of anterior cruciate ligament (ACL) graft size and examine possible differences in tunnel length based on all-epiphyseal drilling method.MethodsOne hundred one patients 5–18 years of age with magnetic resonance imaging (MRI) of the knee at an outpatient pediatric orthopaedic clinic from 2008 to 2020 were included. ACL and PCL coronal, sagittal, and length measurements were made in all patients. Tunnel length measurements were made in patients with open physes. Statistical analyses were performed to evaluate potential associations in patient bony or ligamentous measurements.ResultsPCL sagittal width and PCL coronal width were statistically significant predictors of ACL sagittal width and ACL coronal width, respectively (p = 0.002, R = 0.304; p = 0.008, R = 0.264). The following equations were developed to calculate ACL coronal and sagittal width measurements from the corresponding measurement on an intact PCL; ACL Coronal Width (mm) = 6.23 + (0.16 x PCL Coronal Width); ACL Sagittal Width (mm) = 5.85 + (0.53 x PCL Sagittal Width). Mean tibial maximum oblique length (27.8 mm) was longer than mean tibial physeal sparing length (24.9 mm). Mean femoral maximum oblique length (36.9 mm) was comparable to mean femoral physeal sparing length (36.1 mm). Both were longer than mean femoral straight lateral length (32.7 mm).ConclusionAn intact PCL is a predictor of native ACL size. Tunnel length differs based on chosen drilling method in all-epiphyseal technique.Level of evidenceDiagnostic Level III.

【 授权许可】

CC BY