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Comparative Study
. 2022 Jan 11;17(1):17.
doi: 10.1186/s13018-022-02912-0.

Adult patients with ACL tears have greater tibial internal rotation in MRI compared to adolescent patients

Chih-Kai Hong  1   2 , Yu-Ju Lin  1 , Ting-An Cheng  1 , Chih-Hsun Chang  1 , Kai-Lan Hsu  1   2   3 , Fa-Chuan Kuan  1   2 , Wei-Ren Su  4   5   6
Affiliations
Comparative Study

Adult patients with ACL tears have greater tibial internal rotation in MRI compared to adolescent patients

Chih-Kai Hong et al. J Orthop Surg Res. .

Abstract

Purpose: To compare the anterior translation and internal rotation of tibia on magnetic resonance imaging (MRI) between adult and adolescent patients with anterior cruciate ligament (ACL) tears.

Methods: Patients who underwent isolated ACL reconstruction from January 2013 to May 2021 were retrospectively reviewed. The exclusion criteria included incomplete data, poor image quality, a prior ACL surgery, and concomitant fractures or other ligament injuries. The enrolled patients were divided into two groups based on their ages: an adult group (age > 19 years) and an adolescent group (15 to 19 years of age). Anterior tibial translation and femorotibial rotation were measured on MRI. A Student's t-test was used for the statistical analysis comparing the adult and adolescent groups.

Results: A total of 365 patients (279 adults and 86 adolescents) were enrolled in the present study. The anterior tibial translation in the adult group (4.8 ± 4.4 mm) and the adolescent group (5.0 ± 4.2 mm) was not significantly different (p = 0.740). On the other hand, the tibial internal rotation in the adult group (5.6 ± 5.0 degree) was significantly greater compared to the adolescent group (4.2 ± 5.6 degree) (p = 0.030). The intraclass correlation coefficients (ICC) of the measured data from two independent observers showed excellent reliability (0.964 and 0.961 for anterior tibial translation and tibial internal rotation, respectively).

Conclusion: The adult patients with ACL tears exhibited significant greater tibial internal rotation compared to the adolescent patients, whereas the magnitude of the anterior tibial translation was similar in both groups. Care should be taken if clinicians plan to establish the cutoff point values for diagnosis of ACL tears using the femorotibial internal rotation angle.

Keywords: Anterior cruciate ligament; Anterior tibial translation; Tibial internal rotation.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
The anterior tibial translation was measured in accordance with the methods described by Kalegowda et al. [13]. The midsagittal plane of the lateral femoral condyle was determined with the assistance of coronal images. The distance between the vertical lines drawn from the posterior aspects of the subchondral bone of the lateral femoral condyle and lateral tibial condyle was measured
Fig. 2
Fig. 2
The femorotibial rotation was measured from images in the axial plane. The angle of the posterior femoral condyles was measured from their most prominent point relative to the horizontal line. Meanwhile, the image that was a cut above the fibular head was chosen, and the angle of the posterior tibia condyles was measured off a horizontal line. The femorotibial rotation was calculated by subtracting the femoral rotation from the tibial rotation
See this image and copyright information in PMC

References

    1. Engebretsen L, Wijdicks CA, Anderson CJ, Westerhaus B, LaPrade RF. Evaluation of a simulated pivot shift test: a biomechanical study. Knee Surg Sports Traumatol Arthrosc. 2012;20(4):698–702. doi: 10.1007/s00167-011-1744-1. - DOI - PubMed
    1. Frank JM, Moatshe G, Brady AW, Dornan GJ, Coggins A, Muckenhirn KJ, Slette EL, Mikula JD, LaPrade RF. Lateral Meniscus posterior root and meniscofemoral ligaments as stabilizing structures in the ACL-deficient knee: A Biomechanical Study. Orthop J Sports Med. 2017;5(6):2325967117695756. doi: 10.1177/2325967117695756. - DOI - PMC - PubMed
    1. Lian J, Diermeier T, Meghpara M, Popchak A, Smith CN, Kuroda R, Zaffagnini S, Samuelsson K, Karlsson J, Irrgang JJ, et al. Rotatory knee laxity exists on a continuum in anterior cruciate ligament injury. J Bone Joint Surg Am. 2020;102(3):213–220. doi: 10.2106/JBJS.19.00502. - DOI - PubMed
    1. Mitchell BC, Siow MY, Bastrom T, Bomar JD, Pennock AT, Parvaresh K, Edmonds EW. Coronal lateral collateral ligament sign: a novel magnetic resonance imaging sign for identifying anterior cruciate ligament-deficient knees in adolescents and summarizing the extent of anterior tibial translation and femorotibial internal rotation. Am J Sports Med. 2021;49(4):928–934. doi: 10.1177/0363546521988938. - DOI - PubMed
    1. Tsai AG, Wijdicks CA, Walsh MP, Laprade RF. Comparative kinematic evaluation of all-inside single-bundle and double-bundle anterior cruciate ligament reconstruction: a biomechanical study. Am J Sports Med. 2010;38(2):263–272. doi: 10.1177/0363546509348053. - DOI - PubMed

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