TOPOGRAPHICAL ANATOMY OF THE INTERCONDYLAR ROOF - A PILOT-STUDY

Anatomical features of the intercondylar roof with respect to the nati ve anterior cruciate ligament and proposed substitute ligament attachm ent sites in anterior cruciate ligament reconstructive surgery were in vestigated. Using cadaveric knees and K wires, radiographs were obtain ed with markers placed on the roof and the tibial acid femoral attachm ent sites. In the knees studied, the intercondylar roof was V shaped w ith distinct anterior and posterior limbs. The posterior limb correspo nded to the radiographic line commonly called Blumensaat's line. The a nterior limb was oriented 25 degrees more vertical than the posterior limb and impinged on the anterior cruciate ligament in extension. In t his pilot study, estimates of the degree of impingement in full extens ion were made by drawing lines representative of 10-mm grafts at selec ted sites on lateral radiographs. A graft placed at the central portio n of the native femoral site to the normal tibial site did not impinge , while a graft placed at the traditional femoral site to an anteromed ial tibial site impinged as much as 8 mm throughout its entire extent. This pilot study presents preliminary, provocative information sugges ting that the intercondylar roof is actually V shaped and that substit ute ligaments placed at attachment sites commonly used today may impin ge over most of their length.