(Fig 2-C.06) Bernard and Hertel’s grid-based technique

https://youtu.be/fVe5J_01GsA

https://youtu.be/uDgqFi3itg0

 

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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