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. 2022 Aug;18(3):376-384.
doi: 10.1177/15563316211041090. Epub 2021 Sep 3.

Narrow Notch Width and Low Anterior Cruciate Ligament Volume Are Risk Factors for Anterior Cruciate Ligament Injury: A Magnetic Resonance Imaging-Based Study

Ravi Gupta  1 , Sanjay Jhatiwal  1 , Anil Kapoor  1 , Ravinder Kaur  1 , Ashwani Soni  1 , Akash Singhal  1
Affiliations

Narrow Notch Width and Low Anterior Cruciate Ligament Volume Are Risk Factors for Anterior Cruciate Ligament Injury: A Magnetic Resonance Imaging-Based Study

Ravi Gupta et al. HSS J. 2022 Aug.

Abstract

Background: The relationship between anterior cruciate ligament (ACL) injury and anatomical structures is still a topic of debate.

Purpose: The aim of this study was to compare knee geometry in demographically matched ACL-injured and ACL-intact athletes.

Methods: We conducted a case-control study comparing 2 groups, each consisting of 55 professional athletes (44 men and 11 women): 1 group with complete ACL tears (cases) and 1 group with intact ACLs (controls). The groups were compared using magnetic resonance imaging (MRI) in terms of intercondylar notch geometry, tibial plateau characteristics, and ACL volume.

Results: Among cases and controls, we found the cases had lower notch width (20.24 ± 2.68 mm vs. 22.04 ± 2.56 mm, respectively) and notch width index (0.29 ± 0.03 vs. 0.31 ± 0.03, respectively). The mean ACL volume in the cases (1181.63 mm3 ± 326 mm3) was also lower than in controls (1352.61 mm3 ± 279.84 mm3). The parameters of tibial slope geometry were comparable between groups. In addition, women had lower ACL volume than men (1254 ± 310 mm3 vs. 890 ± 267 mm3, respectively) and higher medial posterior tibial slope (4.76 ± 2.6 vs. 6.63 ± 1.83, respectively). Among cases, women had narrower notch width than men (16.9 ± 2.42 mm vs. 21.08 ± 2.03 mm). However, notch width index was comparable between male (0.3 ± 0.02) and female (0.28 ± 0.03) cases.

Conclusion: Our findings suggest that narrow notch width and low ACL volume may enhance the risk of ACL injury among athletes. There was no association found between posterior tibial slope and ACL injury between athletes with injured ACLs and controls. Further study is indicated.

Keywords: ACL; ACL volume; notch width; tibial slope.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1.
Fig. 1.
Calculation of notch width.
Fig. 2.
Fig. 2.
Longitudinal tibial axis.
Fig. 3.
Fig. 3.
Sagittal planes are chosen at mediolateral centers of plateaus for measuring slopes.
Fig. 4.
Fig. 4.
Lateral tibial plateau slope (LTPS).
Fig. 5.
Fig. 5.
Medial tibial plateau slope (MTPS).
Fig. 6.
Fig. 6.
Depth of medial tibial plateau (MTPD).
Fig. 7.
Fig. 7.
ACL marked in a section. ACL anterior cruciate ligament.
See this image and copyright information in PMC

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