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Ideal Graft Femoral Tunnel Center
1️⃣ Traditional Method on Conventional X-ray
✅ Assessment in the Sagittal Plane:
- The position of the femoral tunnel can be evaluated in the sagittal plane by drawing two specific lines:
- Posterior Cortex Line: A line along the posterior cortex of the femur.
- Roof Line: Another line along the roof of the intercondylar notch.
✅ Intersection Point: The inferior portion of the tunnel should be located at the intersection of these two lines.
Reference: AJR 2010; 194:476–484.
2️⃣ Bernard and Hertel’s Grid-Based Technique Using 3D CT Imaging
✅ Placement Reporting: The placement of the femoral tunnel is reported using two ratios, commonly referred to as the “Bernard and Hertel grid”.
- A more recent study reported mean ratios across anatomical studies of 27% in the deep-shallow direction and 34% in the high-low direction.
✅ Clinical Implications:
- Deviations from the optimum placement may result in instability during the range of motion, loss of range of motion, and predisposes to re-rupture.
Reference: Skeletal Radiol (2013) 42:1489–1500.
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