Locating femoral graft placement from lateral radiographs in anterior cruciate ligament reconstruction: A comparison of 3 methods of measuring radiographic images

Graft positioning in anterior cruciate ligament (ACL) reconstruction is usu ally documented from lateral postoperative radiographs. The purpose of this study was to compare 3 measurement methods for femoral graft placement in 50 patients with ACL reconstruction. Intraoperative radiographic images wer e obtained and divided into 2 groups. The first group showed suboptimal pro jections, with out-of-plane rotations causing the femoral condyles to not b e perfectly overlapped. The second group showed good projection, with optim al rotation and fully overlapped femoral condyles. In our study, only the m easurement technique described by Amis produced data with the least measure ment error when multiple observers assessed both groups. It is recommended that Amis' method be used to measure femoral ACL graft position so that rel iable data are available for comparison between medical centers.