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Related Concept Videos

Bones of the Lower Limb: Femur and Patella01:16

Bones of the Lower Limb: Femur and Patella

The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the neck...

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Bi-socket ACL reconstruction using hamstring tendons: high versus low femoral socket placement.

Yukiyoshi Toritsuka1, Hiroshi Amano, Yuzo Yamada

  • 1Department of Orthopaedic Sports Medicine, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-0064, Japan. toritsuka@kanrou.net

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|March 17, 2007
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Summary

The location of the femoral socket in anterior cruciate ligament (ACL) reconstruction impacts patient outcomes. Lower femoral socket placement in ACL surgery led to better subjective results, though objective measures were similar across both high and low placements.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomedical Engineering

Background:

  • Anterior cruciate ligament (ACL) reconstruction is a common surgical procedure.
  • The precise placement of femoral tunnels is crucial for restoring knee biomechanics.
  • Bi-socket techniques offer potential advantages in ACL reconstruction.

Purpose of the Study:

  • To investigate the impact of high versus low femoral socket placement in bi-socket ACL reconstruction.
  • To compare subjective and objective outcomes between different femoral socket positions.
  • To determine the optimal femoral socket location for ACL graft function.

Main Methods:

  • A comparative study involving 261 patients (Group H) with high-femoral sockets and 43 patients (Group L) with low-femoral sockets.
  • All patients underwent bi-socket ACL reconstruction with a minimum 24-month follow-up.
  • Outcomes were assessed using the IKDC Knee Examination Form and KT-1000 anterior laxity measurements.

Main Results:

  • Group L (low-femoral socket) showed significantly better subjective outcomes (P = 0.007).
  • Objective laxity measurements (KT-1000) revealed no statistically significant differences between Group H and Group L.
  • Over 90% of patients in both groups achieved satisfactory objective clinical outcomes.

Conclusions:

  • Bi-socket ACL reconstruction yields objectively satisfactory results in the majority of patients.
  • Low-femoral socket placement in bi-socket ACL reconstruction is associated with superior subjective patient-reported outcomes.
  • Femoral socket positioning is a key factor influencing subjective recovery after ACL reconstruction.