An Anatomic Study On The Femoral Attachment Of Anterior Cruciate Ligament By Combined CT And MRI Three-dimensional Reconstruction

[Objective] To study the femoral insertionof anterior cruciate ligament (ACL)by combined CT and MRI three-dimensional reconstruction, so that to provide anatomic reference for ACL reconstruction.[Method] Ninety-two knees from the both knees of 46 volunteers were scanned with CT and MRI. Combined CT and MRI three-dimensional imaging of the knee were reconstructed, subsequently, the dimension of the femoral insertion of ACL, and its relationship to surrounding structures were measured using Mimics and Geomagic software. The data was statistically analyzed with SPSS 17.0 software.[Result] The area of ACL femoral attachment was 103.6±13.0mm2 in male and 86.5±11.6mm2 in female respectively. The long axis was 15.3±1.7mm in male and 14.3±2.1mm in female, and the short axis was 8.5±1.8mm in male and 5.5±1.9mm in female. In addition, the shortest distance to the posterior margin of the femur was 4.1±1.7mm in male and 2.9±1.2mm in female, and the shortest distance to the distal margin of the femur was 5.4±1.3mm in male and 4.0±1.3mm in female. There were significantly statistical differences between male and female in above-mentioned parameters (P<0.05). However, there were no significantly statistical differences between the two genders in the shortest distance to the internal margin of the femur (2.3±1.3mm in male and 2.3±1.3mm in female),and the angle between axis of the attachment and the longitudinal axis of the femur (13.3±5.8°in male and10.9±6.3° in female). (P>0.05).[Conclusion] There is significant variation in the shape and dimension of the ACL femoral insertion among these health volunteers, associated with remarkable difference in area of the insertion between the two genders. It implies that morphology, location and sizes of the ACL,even sex of the patients should be taken into account for individualized reconstruction of ACL.