Lateral Topographic Study Of Medial And Lateral Femoral Condyle Of Normal Adult

With the popularity of competitive sports, ligaments injury of knee joints and patellar dislocation get more and more. Reconstruction of Medial patellofemoral ligament(MPFL), Medial collateral ligament(MCL), Lateral collateral ligament(LCL) and Popliteus tendon,(PT) are taken to be more and more seriously. The stability of MCL and LCL reconstruction is better than that of repair. But femurs of MFPL、MCL、LCL、PT are on the outside of the joints, and there is no agreement on how to position, what’s more, it is hard to position accurately. Now there are three common positioning methods: ①open operation: it is to position on the basis of ligament remnants. But the trauma is too serious, and the occurrence rates of joint-rigidity, adhesion and other complications are too high. ②Intraoperative X-ray line perspective: it is to position attachment point of ligament femur on the basis of osseous marks. But the operation procedures of this method are too complex and the accuracy is low. positioning on ③the basis of medial and lateral condyles of femurs. At present, few scholars take lateral condyle of femur as reference mark to position Lateral collateral ligament. There is no literature reports about relative height of lateral epicondyle the highest point or whether the position is stable or not. There are scholars who utilize three-dimension reconstruction to describe surface morphology of ligament attachment. The purpose of this study are as the following: ① Adopt 320 CT to scan volumes of femur condyles of volunteers and make three-dimension reconstruction, study medial and lateral surface features of femur condyles. Measure the height of medial epicondyle and lateral epicondyle the highest points and study whether the relative position is stable or not so as to make sure whether the highest points of medial epicondyle and lateral epicondyle and their relative position can be taken as reference points to position ligament femurs. ②Mark the the highest points of medial epicondyle and lateral epicondyle of femurs, femur attachment center of MFPL、MCL、LCL、PT, then make 320 CT three-dimension reconstruction, and measure the distance between distal point and the highest point of ligament femurs and orientation parameter. ③ Explore reconstruction micro-invasive positioning technology of four ligaments.This study selects domestic normal adult volunteers from July 2013 to July 2014 to conduct 320 CT volume scanning for the three-dimensional reconstruction of distal femur, and there are two groups,including 58 male knee-joints and 58 female knee-joints. Average age is(32.8±9.9) years old. Average stature is(169.1±8.2)cm. Draw tag lines on the surface of Medial femoral epicondyle and lateral femoral epicondyle respectively, including tag lines which mark front and back and tag lines which mark up and down.Measure the plain height between the highest points of medial femoral epicondyle and lateral femoral epicondyle and distal cartilage margin of femoral condyle, and the length of that from between the high point and the tag lines(tag lines which mark front and back and tag lines which mark up and down). At the same time, mark the highest points of medial femoral epicondyle and femur attachment center of LCL and PT for 13 fresh frozen adult knees samples, and make 320 CT scanning reconstruction for the highest points of medial femoral epicondyle, femur attachment centers of MCL and MFPL, to measure the distance and orientation between the highest point of bones and the center of ligament attachment points. Measuring results in this hospital demonstrate: The relative height between lateral highest point of medial femoral condyle and distal cartilage margin is(6.91±1.62) mm for the male and(6.82±1.43) mm for the female, p>0.05. The relative height between lateral highest point of lateral femoral condyle and distal cartilage margin is(5.79±1.38) mm for the male and(6.11±1.84) mm for the female, p>0.05. The relative distance from the highest points of medial femoral epicondyle to the back condyle is(44.7±8.1) % of the distance between front and back for the male, and(48.5±6.1)%,p<0.05, and there is significant difference. And the distance from the highest points of medial femoral epicondyle to distal cartilage margin is(63.9±7.8)% of the the distance between up and down for the male, and(64.8±7.8) % for the female, p>0.05. The distance from the highest point of lateral femoral epicondyle to back condyle is(33.8±3.0) % of the distance between front and back for the male, and(32.8±4.6)% for the female,p>0.05. The distance from the highest point of lateral femoral epicondyle to distal cartilage margin is of the distance between the up and the down(59.5±4.1)% for the male, and(60.8±3.7)% for the female,p>0.05. The MPL lies(12.79±1.68)mm away behind the highest points of medial femoral epicondyle with an angle of(37.21±1.16)°, Medial collateral ligaments lie(4.93±0.71)mm away behind the highest points of medial femoral epicondyle with an angle of(37.6±2.9)°, The lateral collateral ligament lie(2.96±0.36)mm away behind the highest points of lateral femoral epicondyle with an angle of(50.5±5.4)°, popliteus tendons lie(10.52±0.86)mm away behind the highest points of lateral femoral epicondyle with an angle of(38.07±2.57)°.Conclusions: There are constant osseous swell in medial and lateral femoral condyle, which can be reference point in the reconstruction of ligament. The data in the experiment can be reference in the clinical trials.