Medial Femoral Condyle

The studies were carried out using circular cylindrical plugs of cartilage and bone that were cut from the medial femoral condyles of adult steers (approximately 2 years old). The... 

Fig. 10.6 The proposed noncontact ACL injury mechanism, (a) An unloaded knee, (b) When valgus loading is applied, the MCL becomes taut and lateral compression occurs, (c) This compressive load causes a lateral femoral posterior displacement, probably due to the posterior slope of lateral tibial plateau, and the tibia translates anteriorly and rotates internally, resulting in ACL rupture, (d) After the ACL is tom, the primary restraint to anterior translation of the tibia is gone. This causes the medial femoral condyle to also be displaced posteriorly, resulting in external rotation of the tibia...

The optimum location for the FAM portal during ACL reconstruction should avoid cartilage damage to the medial femoral condyle. This portal is usually created just above the medial meniscus and approximately 2.5 cm medial to the medial border of the patellar tendon. Using preoperative three-dimensional computed... 

The FAM portal location should be as low as possible above the medial meniscus while avoiding the medial meniscus and without blowing out of the posterior wall of the lateral femoral condyle. At this time, assess the distance between the spinal needle and the articular cartilage of the medial femoral condyle with the knee in 120° of flexion, and avoid the articular cartilage of the medial femoral condyle while reaming the femoral tunnels. Rotate the arthroscope to determine whether the spinal needle is positioned too closely to the medial femoral condyle (Fig. 15.2b). Once the position of the FAM portal is determined, advance a number 11 scalpel blade toward the ACL insertion of the femur under arthroscopic... 

The optimum FAM portal position was previously studied using preoperative 3D CT [14]. Based rai the results of that study, the optimum location for the FAM portal was less than 30 mm from the medial border of the patellar tendon in male patients and less than 25 nun in female patients. Furthermore, in female patients less than 160 cm tall, it should be placed 20 mm from the medial border of the patellar tendon. This optimum location for the FAM portal during ACL reconstruction using the FAM portal technique should be used to avoid damaging the medial femoral condyle cartilage (Fig. 15.3a, b). 

In this study, the FAM was used to create the femoral tunnels, while viewing through the central anteromedial portal. This resulted in the creation of a femoral tuimel within the anatomical femoral ACL attachment independent of the tibial tuimel [10, 11, 22-24]. Additionally we recommend using 3D CT for preoperative prediction of the optimal site of incision for the FAM portal to enable creation of femoral tunnels of optimal length and orientation without damaging the articular cartilage of the medial femoral condyle [21]. 

Radiographs can identify associated avulsion injuries, such as Pelegrini-Stieda lesions (avulsion of the medial femoral condyle at the origin of the medial collateral ligament) and Segond lesion (avulsion fracture of the lateral tihial plateau). Segond fractures are associated with LCL, ACL and meniscal tears (Sferopoulos et al. 2006). 

There is a defect in the subchondral region of the distal femur with partial or complete separation of the bone fragment which is most often seen on the postero-lateral aspect of the medial femoral condyle (about 80% of cases), and less often seen on the posterior aspect of the lateral femoral condyle. It is more... 

On a lateral radiograph, the knee lesion may appear sclerotic, typically on the lateral aspect of the medial femoral condyle. A tunnel view may demonstrate medial condylar defects, and this may be better profiled with the knee in varying degrees of flexion. The lesion may appear sclerotic if the presentation is delayed. 

Collagen membrane Cartilage Chondrocytes Medial femoral condyle of New Zealand rabbits... 

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