Variability in the Clock Face View Description of Femoral Tunnel Placement in ACL Reconstruction Using MRI-Based Bony Models

J Knee Surg DOI: 10.1055/s-0038-1626736Though controversial, the “clock face view” of the intercondylar notch remains a way some surgeons communicate regarding placement of the femoral tunnel in anterior cruciate ligament reconstruction. The purpose of this study was to quantify the differences in angle measurement between several previous descriptions of the clock face view by using a new reference standard. Three-Tesla magnetic resonance imaging (MRI) was used to scan 10 human knees to create three-dimensional MRI-based bony models which were used for measurements. A standardized clock face view was developed with the knee flexed to 90° using the junction of the cartilage and cortex of the medial and lateral surfaces of medial and lateral femoral condyles as the 3 o'clock and 9 o'clock, respectively, with the 12 o'clock established as the midpoint of the roof of the intercondylar notch. With the knee viewed at 90° of flexion, an “idealized” femoral tunnel position was plotted on the medial wall of the lateral femoral condyle at 30° (corresponding to the 10 o'clock or 2 o'clock position). The clock faces as described by Edwards et al, Heming et al, and Mochizuki et al were each then overlaid on this same model and the difference in measurement calculated. The average angles measured when the previously described clock faces were projected onto the idealized clock face view comparing a mark made at 30° were 47.7°, 7.2°, and 49.8...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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Conclusion An accelerated return to sport, particularly in the presence of poor lower limb function, may be implicated in posttraumatic KOA development. Level of evidence III
Source: PMandR - Category: Rehabilitation Source Type: research
ConclusionPrior to ACL revision surgery, bone tunnel measurements can be done using a 3D T1-MRI sequence in low-field MRI. MRI measurements show the same accuracy as CT scans. Preoperative radiation exposure in mainly young patients could be reduced. Also the costs of an additional CT scan could be saved.
Source: Skeletal Radiology - Category: Radiology Source Type: research
AbstractObjectiveThe magnetic resonance imaging (MRI) appearance of the anterolateral ligament (ALL) has been described. However, the appearance  of this structure and injury, in the presence of anterior cruciate ligament (ACL) injury, is less well defined. We studied the incidence of injury to the ALL and the pattern of this injury on MRI.Materials and methodsFollowing Institutional Review Board approval, a retrospective study of 375 consecutive MRI studies was performed. Cases were identified from a prospective database of ACL reconstruction patients. Following exclusions, 280 MRIs (277 patients; 197 males: 80 femal...
Source: Skeletal Radiology - Category: Radiology Source Type: research
Tunnel widening after anterior cruciate ligament reconstruction (ACLR) is influenced by the surgical and fixation techniques used. Computed tomography (CT) is the most accurate image modality for assessing tunnel widening, but magnetic resonance imaging (MRI) might also be reliable for tunnel volume measurements. In the present study tunnel widening after ACLR using biodegradable interference screw fixation was compared with all-inside ACLR using button fixation, with tunnel volume changes being measured on CT and MRI scans.
Source: The Knee - Category: Orthopaedics Authors: Source Type: research
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Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research
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Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
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Source: Journal of Magnetic Resonance Imaging - Category: Radiology Authors: Tags: Original Research Source Type: research
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Source: The American Journal of Sports Medicine - Category: Sports Medicine Authors: Tags: Knee ligaments, ACL, Imaging, magnetic resonance Source Type: research
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Source: Arthroscopy Techniques - Category: Surgery Source Type: research
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Source: International Journal of Sports Medicine - Category: Sports Medicine Authors: Tags: Orthopedics & Biomechanics Source Type: research
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