Optimal Condition to Create Femoral Tunnel Considering Combined Influence of Knee Flexion and Transverse Drill Angle in Anatomical Single-Bundle ACL Reconstruction Using Medial Portal Technique: 3D Simulation Study

Figure 1

(a) 3D reconstructed model of femur was aligned in a true lateral position, where medial and lateral femoral condyles were superimposed. (b) The medial femoral condyle was virtually eliminated from the original 3D model at the most anterior aspect of the intercondylar notch, and A 4 × 4 grid was drawn on the medial wall of the lateral femoral condyle from a true medial view of the femur established at 90° of knee flexion. The femoral footprint center was determined according to the following coordinates: The distance parallel to the Blumensaat line was 28.4% along the line measured from the posterior border. The distance perpendicular to the Blumensaat line was 35.7% along the line measured from the Blumensaat line. (c) Transepicondylar axis was established as rotation axis of flexion to make change of the flexion angle.

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