title: Radiographic femoral bicondylar width predicts anterior cruciate ligament insertion site sizes.
abstract: OBJECTIVE
  The purpose of this study was to determine whether radiographic femoral bicondylar width predicts intra-operative anterior cruciate ligament (ACL) insertion site sizes.
  
  
  METHODS
  Seventy-three consecutive patients (39 males and 34 females; mean age 25.2 years ± 10.2) who underwent anatomic ACL reconstruction were retrospectively reviewed. Femoral condyle width was measured using a pre-operative anteroposterior (AP) radiograph of the operative knee. Lines were drawn through the anatomic axis of the femur, as well as perpendicularly through the condyles. Bicondylar width was measured as the maximum width across both the medial and lateral femoral condyles utilizing this perpendicular line. The ACL insertion site lengths (in the AP direction) of both the tibia and the femur were measured intra-operatively using a commercially available arthroscopic ruler.
  
  
  RESULTS
  The average bicondylar width was significantly smaller for females compared to males (p < 0.05). The average tibial and femoral insertion site sizes were significantly smaller for females compared to males (p < 0.05). Regression analysis predicted tibial (r2= 0.88) and femoral (r2= 0.90) insertion site sizes based on femoral bicondylar width measurements.
  
  
  CONCLUSIONS
  A simple radiographic measurement of femoral bicondylar width can predict intra-operative tibial and femoral insertion site sizes, which has the potential to assist surgeons in performing individualized ACL reconstruction in cases where MRI scan is unavailable.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Murawski
authors.affiliation: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Antonia F
authors.initials: AF
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. ffu@upmc.edu.
authors.forename: Freddie H
authors.initials: FH
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D011300:Preoperative Care; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D055815:Young Adult
keywords: ACL; Femoral bicondylar width; Insertion site