Tibial ACL insertion site length: correlation between preoperative MRI and intra-operative measurements

Abstract

III.

Area of the tibial insertion site of the anterior cruciate ligament as a predictor for graft size

“…All these approaches have the aim to optimize restoration of the native ACL and its tibial insertion site. Previous studies reported pre-and intraoperative measurements of the length of the tibial insertion site [14,28]. However, considering that the shape of the tibial insertion site varies, the area of the tibial insertion site is required to ensure proper planning of graft size.…”

“…Intraoperative measurements of the insertion site can be conducted easily using a customized ruler [21]. It was shown that preoperative determination of the length of the tibial insertion site using MRI is possible as well [28]. Furthermore, it could be shown that the size of the graft can be determined preoperatively using MRI measurements [5].…”

Preoperative ultrasound predicts the intraoperative diameter of the quadriceps tendon autograft more accurately than preoperative magnetic resonance imaging for anterior cruciate ligament reconstruction

“…As part of this concept, the graft size should match the individual patient’s anatomy so as to avoid postoperative complications such as graft impingement, high failure rate, and poor patient‐reported outcome scores [6, 8, 23, 24, 29–31, 38, 44]. Accurate preoperative assessment of potential autograft size [notably, the cross‐sectional area (CSA)] aids in assuring that the dimensions of the native ACL can be adequately recapitulated with reconstruction [16, 21, 42, 46].…”

Anatomic anterior cruciate ligament reconstruction: Freddie Fu's paradigm

“…Midsagittal and midcoronal T1 MRI sequences can be used to measure the size of the tibial footprint, ACL length, inclination angle, and thickness of potential autograft donor sites including the patellar, quadriceps, and hamstring tendons (Figure 2) [43][44][45]. Additional oblique coronal and sagittal sequences assist in identifying partial or single-bundle ACL injuries (Figure 3) [46,47].…”