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. 2023 Sep 7;11(9):23259671231194928.
doi: 10.1177/23259671231194928. eCollection 2023 Sep.

Investigation of Morphometric Factors Associated With Adolescent ACL Rupture

Serhat Akcaalan  1 , Abdurrahim Kavaklilar  1 , Ceyhun Caglar  1 , Mahmut Ugurlu  2 , Metin Dogan  2 , Mustafa Akkaya  2
Affiliations

Investigation of Morphometric Factors Associated With Adolescent ACL Rupture

Serhat Akcaalan et al. Orthop J Sports Med. .

Abstract

Background: There are no definitive anatomic morphometric risk factors for adolescent anterior cruciate ligament (ACL) injury.

Purpose: To compare the parameters used to define the tibial and femoral morphometric structure of the knee between adolescent patients with and without ACL rupture.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Included were magnetic resonance imaging (MRI) scans and radiographs of 115 patients aged 10 to 17 years who were evaluated for ACL rupture at a single institution between February 1, 2019, and January 31, 2022. Images from 115 patients with intact MRI scans were included as controls. We investigated the following imaging parameters: tibial slope (on lateral radiograph), lateral condylar height, tibial sulcus height, medial condylar height, condylar width, intercondylar notch with, intercondylar notch angle, notch index, eminence width, tibial plateau width, eminence width/tibial plateau width, medial/lateral/overall eminence height, medial plateau depth, and 2 different eminence angles. Parameters were compared between groups using the chi-square, Fisher exact, Student t, or Mann-Whitney U test, as appropriate. Receiver operating characteristic analysis was conducted for cutoff values of significant parameters.

Results: There were no significant differences in age, sex, or side affected between groups. Only the medial plateau depth was found to be statistically significant between the ACL rupture and ACL intact groups (2.6 vs 2.2 mm; P = .015). A statistically significant cutoff value could not be obtained for the medial plateau depth.

Conclusion: Medial plateau depth was found to be significantly greater in adolescent patients with ACL rupture compared with ACL-intact controls.

Keywords: ACL rupture; adolescents; anterior cruciate ligament; morphometric study.

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Conflict of interest statement

The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flowchart of study group selection. ACL, anterior cruciate ligament; MCL, medial collateral ligament; MRI, magnetic resonance imaging; PCL, posterior cruciate ligament.
Figure 2.
Figure 2.
(A) Tibial slope measurement on true lateral radiograph. (B) Axial and (C) coronal MRI scan measurements of femoral condylar width and intercondylar notch width. Femoral condylar width was measured with the line connecting both epicondyles, and notch width was measured by drawing a line parallel to the line connecting the epicondyles from the widest part of the intercondylar notch. (D) Axial and (E) MRI scan measurement of femoral intercondylar notch angle. MRI, magnetic resonance imaging.
Figure 3.
Figure 3.
(A) Axial MRI measurements of medial femoral condylar height, tibial sulcus height, and medial femoral condylar height. (B-E) Coronal MRI measurements: (B) eminence width and tibial plateau width, (C) medial and lateral eminence height, (D) eminence angle 1, and (E) eminence angle 2. (F) Medial plateau depth on sagittal MRI. MRI, magnetic resonance imaging.
Figure 4.
Figure 4.
Graph showing ROC curve analysis of medial plateau depth. ROC, receiver operating characteristic.
See this image and copyright information in PMC

References

    1. Ahmad R, Patel A, Mandalia V, Toms A. Posterior tibial slope: effect on, and interaction with, knee kinematics. JBJS Rev. 2016;4(4):e31-e36. - PubMed
    1. Akhavi Milani A, Motallebzadeh Khanamiri M, Mahmoudpour M. The geometric features of tibiofemoral joint associated with anterior cruciate ligament injury: reliability of measurements on conventional MRI. Eur J Radiol Open. 2022;9:100420. - PMC - PubMed
    1. Alentorn-Geli E, Pelfort X, Mingo F, et al.. An evaluation of the association between radiographic intercondylar notch narrowing and anterior cruciate ligament injury in men: the notch angle is a better parameter than notch width. Arthroscopy. 2015;31(10):2004-2013. - PubMed
    1. Al-Saeed O, Brown M, Athyal R, Sheikh M. Association of femoral intercondylar notch morphology, width index and the risk of anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):678-682. - PubMed
    1. Bernhardson AS, Aman ZS, Dornan GJ, et al.. Tibial slope and its effect on force in anterior cruciate ligament grafts: anterior cruciate ligament force increases linearly as posterior tibial slope increases. Am J Sports Med. 2019;47(2):296-302. - PubMed

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