Comparative Analysis of Sagittal-Plane Radiographic Landmarks Used to Identify the Femoral Attachments of Lateral Knee Structures

Kremen, Thomas J.; Haggerty, Erin K; Chahla, Jorge; Eberlein, Samuel; Nelson, Trevor; Schroeder, Grant; Metzger, Melodie F.

doi:10.1016/j.arthro.2020.07.006

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…However, according to Kremen et al., 16 there is a variability of the anatomy of lateral knee structures and a lack of reproducible radiographic criteria to identify these structures.…”

Section: Anatomic Landmarksmentioning

confidence: 99%

Percutaneous Lateral Collateral Ligament Release for Arthroscopic Procedures of the Knee: The “Lateral Pie-Crusting”

Samitier¹,

Gambín²,

Sáenz³

et al. 2022

Arthroscopy Techniques

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“…However, according to Kremen et al., 16 there is a variability of the anatomy of lateral knee structures and a lack of reproducible radiographic criteria to identify these structures.…”

Section: Anatomic Landmarksmentioning

confidence: 99%

Percutaneous Lateral Collateral Ligament Release for Arthroscopic Procedures of the Knee: The “Lateral Pie-Crusting”

Samitier¹,

Gambín²,

Sáenz³

et al. 2022

Arthroscopy Techniques

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“…This can, in part, be attributed to the challenges involved in capturing sagittal plane radiographs reliably. 6 – 8 Dynamic factors such as patient position need to be taken into consideration. 1 , 9 For example, assessment of the sagittal mechanical axis (sMA) should be done on an image where the knee is in maximal extension, this often must be done in the supine position to allow relaxation of the hamstring muscles.…”

Section: Introductionmentioning

confidence: 99%

Correlation between Femoral Neck Version, Sagittal Femoral Bowing Angle and Sagittal Offset of the Femoral Head from the Distal Femur Axis in an Osteological Collection

McClure¹,

Liu²,

Ho³

2023

Strategies in Trauma and Limb Reconstruction

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A bstract Aim Radiographic analysis of lower limb alignment is crucial for the planning and evaluation of deformity correction. Assessment in the sagittal plane is often overlooked compared with the coronal plane for a variety of reasons. We aimed to investigate the relationship between the femoral head in the sagittal plane and femoral neck version in the axial plane, and how sagittal femoral bowing angle (sFBA) may contribute. Materials and methods Twenty-five each of high (1–2 standard deviations above mean), normal (2.5° below to 2.5° above the mean), and low (1–2 standard deviations below the mean) version femurs were randomly selected from an osteological collection database, photographed and measured for sFBA and sagittal offset of femoral head from the distal femur axis. Lines were drawn within the proximal and distal quartiles of the shaft to create sFBA. The offset of the distal quartile line and the femoral head was also measured. High intra- and inter-observer correlations were established. The relationship between parameters was assessed using the Pearson coefficient ( r ). Results Sagittal offset of the femoral head from the distal femur axis was found to be highly correlated with sFBA ( r = 0.78), and only mildly with femoral neck version ( r = 0.52). Sagittal femoral bowing angle and femoral neck version share no relationship ( r = 0.05). Conclusions Neither the sFBA nor sagittal femoral head offset is strongly associated with femoral neck version. Clinical significance Our data reinforce the need for long leg lateral films to include the femoral head in sagittal deformity analysis, as imaging limited to the knee will not account for the effect of bowing on femoral head position. How to cite this article Ho D, Liu RW, Mcclure PK. Correlation between Femoral Neck Version, Sagittal Femoral Bowing Angle and Sagittal Offset of the Femoral Head from the Distal Femur Axis in an Osteological Collection. Strategies Trauma Limb Reconstr 2023;18(1):12–15.

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“…The lack of reproducible radiographic criteria to identify these structures suggests that radiographic landmarks should not be relied on to identify the placement of femoral grafts or fixation devices. 10 MRI is commonly used for evaluating lateral knee ligament structures. Can an MRI evaluation of the ALL be trusted?…”

mentioning

confidence: 99%

Editorial Commentary: Lateral Extra-Articular Tenodesis Results in Better Stability After Anterior Cruciate Ligament Reconstruction for Patients With High-Grade Pivot Shifts

Barber¹

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Magnetic resonance imaging of the torn anterior lateral ligament (ALL) is inconsistent and subject to significant intra-and interobserver variability. Like that of an anterior cruciate ligament (ACL), an ALL tear can vary in degree (first, second, or third) and location (tibial or femoral side). These variations may impact the appropriate surgical intervention. Relevant biomechanical data indicate that the deep iliotibial band fibers are more important than the ALL in controlling pivot shift. Lateral compartment overconstraint after ALL reconstruction does not appear to be a biomechanical or clinical issue. An ALL reconstruction creates a nonisometric construct (tight in extension and lax in flexion), allowing physiologic internal tibial rotation at 90 flexion, whereas lateral extra-articular tenodesis (LET) is more isometric, limiting physiologic internal tibial rotation at 90 flexion. The indications for a combined ACL/ALL reconstruction are evolving, but a Segond fracture and ligamentous hyperlaxity of 5 using the modified Beighton system seem reasonable. An ACL/LET reconstruction results in better stability for patients with high-grade pivot shifts.

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Comparative Analysis of Sagittal-Plane Radiographic Landmarks Used to Identify the Femoral Attachments of Lateral Knee Structures

Cited by 4 publications

References 22 publications

Percutaneous Lateral Collateral Ligament Release for Arthroscopic Procedures of the Knee: The “Lateral Pie-Crusting”

Percutaneous Lateral Collateral Ligament Release for Arthroscopic Procedures of the Knee: The “Lateral Pie-Crusting”

Correlation between Femoral Neck Version, Sagittal Femoral Bowing Angle and Sagittal Offset of the Femoral Head from the Distal Femur Axis in an Osteological Collection

Editorial Commentary: Lateral Extra-Articular Tenodesis Results in Better Stability After Anterior Cruciate Ligament Reconstruction for Patients With High-Grade Pivot Shifts

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