The Morphometric Study on Cruciate and Patellar Ligaments in Korean Adults

Kim, Dong Wook; Roh, Kwon Jae; Yoo, Woo Kyung; Chung, In Hyuk

Abstract

In the endoscopic one-incision anterior cruciate ligament(ACL) reconstruction, placing the graft's tendon-bone interface flush with the intraarticular femoral tunnel results in frequent distal graft protrusion. On the contrary, we occasionally found that the intraarticular posterior cruciate ligament(PCL) length was longer than patellar tendon length and had a great difficulty in performing the endoscopic one-incision technique of PCL reconstruction. The purpose of this study is to get a certain guideline in the endoscopic one-incision technique of cruciate ligament reconstruction by measuring intraarticular distance of ACL, PCL and patellar tendon and by measuring distance between the insertion of pes anserinus and medial tibial plateau in 19 cadaveric knees. The results were as follows; 1. The average patellar tendon length was 36.2±4.7mm(range 24.7-45.0). 2. The average ACL length was 23.7±3.9mm(range 16.5-30.3). 3. The average PCL length was 32.7±3.8mm(range 25.4-41.0). 4. The average distance between the insertion of pes anserinus and medial tibial plateau was 38.3±5.4mm(range 27.2-53.6). Clinical Relevance: Since Korean patellar tendon is shorter than Caucasian's and intraarticular distance of ACL is same as Caucasian's, graft-tunnel mismatch doesn't seem to be a major problem with the accurate technique of the endoscopic one-incision ACL reconstruction in Korean patients. It is possible to interfere with the pes anserinus if the length of the tibial tunnel is needed more than 44.8 mm, It is very difficult to perform an endoscopic one-incision PCL reconstruction if the length of patellar tendon is less than 35mm because intraarticular distance of PCL is sometimes longer than patellar tendon in such cases.