Comparison of two methods for determining Blumensaat's line
Author(s):
Gulan G. (Croatia)
,
Gulan G. (Croatia)
Affiliations:
Gulan L.
,
Gulan L.
Affiliations:
Veljkovic Vujaklija Danijela
,
Veljkovic Vujaklija Danijela
Affiliations:
Jurdan H.
Jurdan H.
Affiliations:
ESSKA Academy. Gulan G. 05/09/18; 209651; P11-1945
Gordan Gulan
Gordan Gulan
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Abstract
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Objectives: Blumensaat's line (BL) is a line on lateral radiograph of the knee that corresponds to the roof of the intercondylar notch. It is often used for indicating the position of the patella as normally it intersects the lower pole. It can also suggest anterior cruciate ligament (ACL) injury as the normal ACL Blumensaat angle is less than 15°. BL can be used for determining the course of the ACL graft as well for finding the center of the ACL femoral footprint using quadrant method. According to our knowledge there is no standardized method for defining the BL position. Furthermore, recent studies suggest that the femoral notch roof is not always straight which can alter the position of the BL. The aim of this study was to compare the two methods of drawing the BL.

Methods: The 150 random selected true lateral radiographs of the knee from our database were analyzed. The age of the patients ranged from 18 - 65. The knees with high grade of osteoarthrtic changes were excluded as well as radiographs with signs of open physis. On each x-ray we drew two lines. The first line was set between the most anterior point (A) of BL which corresponds with the beginning of the femoral notch roof and the second point (B) that was set at the intersection of the posterior femoral cortex and the BL. The second line was set between point A and the most prominent part of the posterior convexity of the BL. The angle between these two lines was measured.

Results: In all examined x-rays the first and second line did not completely coincide. They formed an angle with an average of 9,90 degrees with the SD of 2,517 (range from 4,50 - 15,78).

Conclusions: Our results show the necessity to find a standardized method for determining the BL. The deviation between two examined methods of drawing BL can be up to 16 degrees. Such great deviation can significantly influence measurements in which the BL is used as a referential line. We proposed the first method as a standard for determining BL, because posterior convexity varies in size and can significantly affect the position of the BL

Keywords:
Blumensaat's, knee, radiography
Objectives: Blumensaat's line (BL) is a line on lateral radiograph of the knee that corresponds to the roof of the intercondylar notch. It is often used for indicating the position of the patella as normally it intersects the lower pole. It can also suggest anterior cruciate ligament (ACL) injury as the normal ACL Blumensaat angle is less than 15°. BL can be used for determining the course of the ACL graft as well for finding the center of the ACL femoral footprint using quadrant method. According to our knowledge there is no standardized method for defining the BL position. Furthermore, recent studies suggest that the femoral notch roof is not always straight which can alter the position of the BL. The aim of this study was to compare the two methods of drawing the BL.

Methods: The 150 random selected true lateral radiographs of the knee from our database were analyzed. The age of the patients ranged from 18 - 65. The knees with high grade of osteoarthrtic changes were excluded as well as radiographs with signs of open physis. On each x-ray we drew two lines. The first line was set between the most anterior point (A) of BL which corresponds with the beginning of the femoral notch roof and the second point (B) that was set at the intersection of the posterior femoral cortex and the BL. The second line was set between point A and the most prominent part of the posterior convexity of the BL. The angle between these two lines was measured.

Results: In all examined x-rays the first and second line did not completely coincide. They formed an angle with an average of 9,90 degrees with the SD of 2,517 (range from 4,50 - 15,78).

Conclusions: Our results show the necessity to find a standardized method for determining the BL. The deviation between two examined methods of drawing BL can be up to 16 degrees. Such great deviation can significantly influence measurements in which the BL is used as a referential line. We proposed the first method as a standard for determining BL, because posterior convexity varies in size and can significantly affect the position of the BL

Keywords:
Blumensaat's, knee, radiography
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