Locating femoral graft placement from lateral radiographs in anterior cruciate ligament reconstruction: a comparison of 3 methods of measuring radiographic images.

Graft positioning in anterior cruciate ligament (ACL) reconstruction is usually documented from lateral postoperative radiographs. The purpose of this study was to compare 3 measurement methods for femoral graft placement in 50 patients with ACL reconstruction. Intraoperative radiographic images were obtained and divided into 2 groups. The first group showed suboptimal projections, with out-of-plane rotations causing the femoral condyles to not be perfectly overlapped. The second group showed good projection, with optimal rotation and fully overlapped femoral condyles. In our study, only the measurement technique described by Amis produced data with the least measurement error when multiple observers assessed both groups. It is recommended that Amis' method be used to measure femoral ACL graft position so that reliable data are available for comparison between medical centers.