KNEE EXTENSION AND ITS RELATIONSHIP TO THE SLOPE OF THE INTERCONDYLARROOF - IMPLICATIONS FOR POSITIONING THE TIBIAL TUNNEL IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTIONS
Sm. Howell et Sj. Barad, KNEE EXTENSION AND ITS RELATIONSHIP TO THE SLOPE OF THE INTERCONDYLARROOF - IMPLICATIONS FOR POSITIONING THE TIBIAL TUNNEL IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTIONS, American journal of sports medicine, 23(3), 1995, pp. 288-294
This study determined that knee extension (range, -30 degrees to 2 deg
rees) and the slope of the intercondylar roof (range, 26 degrees to 46
degrees) vary widely between knees in both men and women. We found a
weak relationship between knee extension and the slope of the intercon
dylar roof (r(2) = 0.207); therefore, roof angle cannot be predicted b
y clinically measuring knee extension. Clinical relevance: A knee with
a given degree of extension can have a variety of different slopes to
the intercondylar roof. Knees with the combination of hyperextension
and a vertically oriented slope to the intercondylar roof are ''unforg
iving'' because they require a more posterior position for the tibial
tunnel to avoid roof impingement and an extensive roofplasty. If the s
urgical objective is to minimize the extent of the roofplasty and avoi
d roof impingement, then consideration should be given to customizing
the placement of the tibial tunnel to account for variability in knee
extension and roof angle when reconstructing the anterior cruciate lig
ament. Studies have shown that isometric graft placement can be achiev
ed with this surgical approach.