scholarly journals Relationship between intercondylar notch angle and anterior cruciate ligament injury: a magnetic resonance imaging analysis

2019 ◽  
Vol 47 (4) ◽  
pp. 1602-1609 ◽  
Author(s):  
Mengquan Huang ◽  
Yubiao Li ◽  
Naiming Guo ◽  
Chunlai Liao ◽  
Bin Yu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Magnetic Resonance Images ◽  
Ligament Injury ◽  
Intercondylar Notch ◽  
Notch Angle ◽  
Anterior Cruciate

Objectives This study was performed to compare the intercondylar notch angle (INA) and tibial slope in patients with and without anterior cruciate ligament (ACL) injury and determine the risk factors and influence of these anatomic variations on ACL injury. Methods Participants with and without non-contact ACL injuries were included in the patient and control groups, respectively. The INA (formed by the femoral axis and Blumensaat line), lateral tibial slope (LTS), and medial tibial slope (MTS) were measured on magnetic resonance images. Comparisons were performed between the two groups. A binary logistic regression model was used to determine the influence of the variables on ACL injury. Results Fifty-two participants were included in each group. The INA was significantly smaller and the LTS was significantly greater in the patients than in the controls. No difference was found in the MTS between the two groups. The area under the receiver operating characteristic curve for the combination of the INA and LTS was 0.776 (95% confidence interval, 0.688–0.864). Conclusions The INA was smaller and the LTS was greater in patients with than without ACL tears. The INA in combination with the LTS could be used to predict ACL injury.

scholarly journals A Comparison of Knee Abduction Angles Measured by a 3D Anatomic Coordinate System Versus Videographic Analysis: Implications for Anterior Cruciate Ligament Injury

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711881983 ◽  
Author(s):  
Zoë A. Englander ◽  
Hattie C. Cutcliffe ◽  
Gangadhar M. Utturkar ◽  
William E. Garrett ◽  
Charles E. Spritzer ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Coordinate System ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Coronal Plane ◽  
Ligament Injury ◽  
Abduction Angle ◽  
Knee Abduction ◽  
Anterior Cruciate

Background: Knee positions involved in noncontact anterior cruciate ligament (ACL) injury have been studied via analysis of injury videos. Positions of high ACL strain have been identified in vivo. These methods have supported different hypotheses regarding the role of knee abduction in ACL injury. Purpose/Hypothesis: The purpose of this study was to compare knee abduction angles measured by 2 methods: using a 3-dimensional (3D) coordinate system based on anatomic features of the bones versus simulated 2-dimensional (2D) videographic analysis. We hypothesized that knee abduction angles measured in a 2D videographic analysis would differ from those measured from 3D bone anatomic features and that videographic knee abduction angles would depend on flexion angle and on the position of the camera relative to the patient. Study Design: Descriptive laboratory study. Methods: Models of the femur and tibia were created from magnetic resonance images of 8 healthy male participants. The models were positioned to match biplanar fluoroscopic images obtained as participants posed in lunges of varying flexion angles (FLAs). Knee abduction angle was calculated from the positioned models in 2 ways: (1) varus-valgus angle (VVA), defined as the angle between the long axis of the tibia and the femoral transepicondylar axis by use of a 3D anatomic coordinate system; and (2) coronal plane angle (CPA), defined as the angle between the long axis of the tibia and the long axis of the femur projected onto the tibial coronal plane to simulate a 2D videographic analysis. We then simulated how changing the position of the camera relative to the participant would affect knee abduction angles. Results: During flexion, when CPA was calculated from a purely anterior or posterior view of the joint—an ideal scenario for measuring knee abduction from 2D videographic analysis—CPA was significantly different from VVA ( P < .0001). CPA also varied substantially with the position of the camera relative to the participant. Conclusion: How closely CPA (derived from 2D videographic analysis) relates to VVA (derived from a 3D anatomic coordinate system) depends on FLA and camera orientation. Clinical Relevance: This study provides a novel comparison of knee abduction angles measured from 2D videographic analysis and those measured within a 3D anatomic coordinate system. Consideration of these findings is important when interpreting 2D videographic data regarding knee abduction angle in ACL injury.

scholarly journals Tibial Plateau Slopes in Indian Patients with or without Anterior Cruciate Ligament Injury: A Magnetic Resonance Imaging Study

2016 ◽  
Vol 24 (3) ◽  
pp. 289-293 ◽  
Author(s):  
Shyam Sundar ◽  
Sarthak Patnaik ◽  
Bobur Ubaydullaev ◽  
Vinodh Kolandavelu ◽  
David Rajan
Keyword(s):  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Lateral Tibial Plateau ◽  
Indian Patients ◽  
Males And Females ◽  
Anterior Cruciate

Purpose To compare anterior cruciate ligament (ACL)–injured and ACL-intact patients as well as males and females in terms of tibial plateau slopes to determine their association with ACL injury. Methods Magnetic resonance images (MRI) of the knee of 310 male and 179 female skeletally mature Indian patients (mean age, 40 years) with (n=170+29) or without (n=140+150) ACL injury were reviewed. Their medial and lateral tibial plateau slopes (MTPS and LTPS), medial tibial plateau depth (MTPD), and lateral tibial plateau height (LTPH) were measured using MRI. Results The ACL-injured and ACL-intact groups were comparable in terms of MTPS (6.72° vs. 6.73°, p=0.07), LTPS (5.68° vs. 5.70°, p=0.09), MTD (1.74 vs. 1.73 mm, p=0.356), and LTH (2.21 vs. 2.22 mm, p=0.393). Males and females were also comparable in terms of MTPS and LTPS in both ACL-injured and ACL-intact groups. Conclusion ACL-injured and ACL-intact patients as well as males and females were comparable in terms of the tibial plateau slope parameters.

Does the Curved Nature of the Tibia Influence the Non-Contact ACL Injury?

2012 ◽  
Author(s):  
Ariful I. Bhuiyan ◽  
Javad Hashemi ◽  
James R. Slauterbeck
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Medial Compartment ◽  
Ligament Injury ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
Matlab Programming

The geometry of the tibial plateau and the femoral condyles are emerging as key parameters to be studied as anterior cruciate ligament (ACL) injury risk factors. In this paper, we study the role of curved profile of the medial compartment of the tibia in a sagittal plane as a critical risk factor for the anterior cruciate ligament (ACL) injuries. The curvature of the mid-medial compartment of Tibia in 40 uninjured controls (21 women and 19 men) and 44 anterior cruciate ligament-injured cases (23 women and 21 men) were measured using magnetic resonance images and in-house matlab programming. We hypothesized that the Individuals with a less curved profile in the medial compartment of the tibia are at increased risk of suffering an anterior cruciate ligament injury compared to those with larger curved profiles. Based on t-tests, we established that the uninjured controls had larger curvature (p<0.05) compared to the injured cases. Biomechanically speaking a larger curvature of the tibia could prevent excessive sliding movement of femur with respect to the tibia, and thus could reduce the ACL strain. We suggest that future studies are needed to confirm this relationship and to evaluate the potential role of this curved profile of tibia in the risk of ACL injury.

scholarly journals Diagnostic accuracy of magnetic resonance imaging in detecting anterior cruciate ligament injuries

2017 ◽  
Vol 26 (3) ◽  
pp. 218-23
Author(s):  
Ashfaq Ahmed ◽  
Muhammad A. Razzaque ◽  
Muhammad Kaleem ◽  
Atiq U. Zaman ◽  
Rizwan Akram ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Resonance Imaging ◽  
Anterior Cruciate

Background: The anterior cruciate ligament (ACL) stabilizes the joint during hyperextension and prevents anterior translation over femur. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting ACL injury by taking arthroscopy as gold standard in patients with traumatic knee injury.Methods: Patients fulfilling the study criteria were treated with clinical examination, MRI and then arthroscopy at the Department of Orthopedics and Spine in the Ghurki Trust Teaching Hospital, Lahore. The accuracy, sensitivity and specificity of MRI in diagnosing  the anterior cruciate ligament injury were calculated based on arthroscopic findings. All the data were analyzed using SPSS 17.0 version.Results: A total 185 patients were included. 91.1% were males and 8.9% were females with Mean age of 28.25±0.433. The accuracy of MRI in diagnosing the anterior cruciate ligament was 91.89%, with sensitivity of 93.33%, specificity of 85.71%, positive predictive value of 96.55% and the negative predictive value  of 75%.Conclusion: MRI is accurate and non-invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation to patients with suspicion of ACL injury.

scholarly journals Intercondylar Notch Impingement of the Anterior Cruciate Ligament: A Cadaveric In Vitro Study Using Robots

2018 ◽  
Vol 2018 ◽  
pp. 1-27
Author(s):  
Ross Wilson ◽  
Alan A. Barhorst
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sample Size ◽  
Anterior Cruciate Ligament Injury ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Intercondylar Notch ◽  
Anterior Cruciate ◽  
Femoral Notch

Background. Research has indicated that a smaller intercondylar notch could cause contact between the anterior cruciate ligament and the femoral notch, which may predispose individuals to an increased rate of anterior cruciate ligament injury.Hypothesis. Contact between the lateral notch wall and the anterior cruciate ligament does increase the strain past the structural integrity of the ligament.Study Design. A descriptive laboratory study.Methods. A biomechanical study using robotic manipulators was conducted to investigate the occurrence of impingement in human cadaver specimens. Six cadaveric knees from six donors (three male and three female) were instrumented with a thin force sensor, placed on the lateral wall of the femoral condyle, and a differential variable reluctance transducer (DVRT) was attached to the middle section of the anterior medial bundle of the ACL. The knees were then moved through a series of flexion (5° to 90°), valgus (0 to 7.5°), and external rotation (0 to 7.5°) movements using two interacting robots.Results. The results revealed that impingement occurred in both male and female specimens with a maximum impingement force of 28 N. Impingement occurred more prominently in female knees and in the combination loading of valgus and external rotation for both genders. The corresponding strain due to impingement was small or compressive, with the male knee maximum strain less than 1.28% and the female knee strain less than 7.1% in the worse case conditions.Conclusion. The lack of increased force or strain when impingement occurred indicates that impingement may not affect the healthy function of the knee with a nonstenotic notch. Additionally, the analysis shows that impingement may not be a major contributing factor to anterior cruciate ligament injury, but rather a common occurrence in healthy knees.Clinical Relevance. Impingement within the femoral notch does not appear to be a major contributory factor to ACL injury. Other more severe injuries to the knee would occur before ACL impingement with the femoral notch becoming a contributing factor to ACL injury. The small sample size limits the conclusivity of the results presented in this research; thus, additional large sample size studies are warranted.

scholarly journals Femoral notch and proximal tibial morphology and their relationship with an anterior cruciate ligament injury in the Indian population: A magnetic resonance imaging-based study

2020 ◽  
Vol 1 ◽  
pp. 193-198
Author(s):  
Vishal Huggi ◽  
K. Yogesh ◽  
George Jacob ◽  
Shailesh Pai ◽  
Ajith Kumar ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Resonance Imaging ◽  
Posterior Tibial ◽  
Lateral Posterior ◽  
Anterior Cruciate

Objectives: We aim to study the incidence of anterior cruciate ligament (ACL) injury to proximal tibia bone morphology in Indian patients. Materials and Methods: Forty male subjects who sustained non-contact ACL injury who presented to our center between October 2015 and December 2016 studied and compared to 40 non-ACL injury knee magnetic resonance imaging scans. Notch morphology and both medial and lateral posterior tibial slope measurements were performed and studied. Results: We noted that the difference in notch depth and notch angle between the two groups was not significant. There was a statistically significant higher incidence of ACL injury in patients with smaller notch widths. Both an increased medial and lateral posterior tibial slope did not demonstrate a statistically significant incidence in ACL injury. Conclusion: Notch width is a major contributing risk factor for ACL injury in Indian patients. This is in agreement with previously published literature.

The Lateral Femoral Condyle Index Is Not a Risk Factor for Primary Noncontact Anterior Cruciate Ligament Injury

2021 ◽  
pp. 036354652110572
Author(s):  
Emma K. Nowak ◽  
Mélanie L. Beaulieu ◽  
Bruce D. Beynnon ◽  
James A. Ashton-Miller ◽  
Daniel R. Sturnick ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Conditional Logistic Regression ◽  
Acl Injury ◽  
Tibial Slope ◽  
Magnetic Resonance Images ◽  
Lateral Femoral Condyle ◽  
Anterior Cruciate

Background: The lateral femoral condyle index (LFCI)—a recently developed measure of the sphericity of the lateral femoral condyle—was reported to be a risk factor for anterior cruciate ligament (ACL) injury. However, issues have been raised regarding how the index was measured and regarding the patient group and the knee in which it was measured. Purpose: To investigate the association between the LFCI and the risk of sustaining a primary, noncontact ACL injury, and to examine whether this association was moderated by the posterior-inferior–directed slope of the lateral tibial plateau. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A secondary analysis was conducted of deidentified magnetic resonance images of the uninjured knees of 86 athletes with ACL injury and the corresponding knees of 86 control athletes, matched for sports team, sex, and age. From those images, we measured the LFCI and the posterior-inferior–directed slope of the middle region articular cartilage surface of the tibial plateau’s lateral compartment. Conditional logistic regressions were performed to determine whether the LFCI was significantly associated with ACL injury risk and whether the lateral tibial compartment middle cartilage slope moderated this association. Data were analyzed for female and male participants separately as well as for both groups combined. Results: The LFCI was not found to be significantly associated with experiencing a primary, noncontact ACL injury for all analyses. The lateral tibial slope measure was not found to moderate the association between the LFCI and ACL injury. A conditional logistic regression analysis using the LFCI data of the injured knees, instead of the uninjured knees, of the participants with ACL injury revealed that the LFCI was significantly associated with ACL injury. Conclusion: In this population of athletically active female and male participants, the LFCI was not found to be a risk factor for noncontact ACL injury, regardless of the geometric features of the lateral tibial slope.

Influence of Tibial Eminence Size on the ACL Injury

2011 ◽  
Author(s):  
Ariful I. Bhuiyan ◽  
Javad Hashemi ◽  
Ryan E. Breighner ◽  
James R. Slauterbeck
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Ligament Injury ◽  
Tibial Eminence ◽  
Increased Risk ◽  
Anterior Cruciate

The geometry of the tibial plateau as well as the femoral condyles are emerging as key parameters to be studied as anterior cruciate ligament (ACL) injury risk factors. In this paper, we study the role of tibial eminence size as a potentially important characteristic of the tibial plateau in loading and or protecting the ACL from injury. The volume of Tibial eminence in 52 uninjured controls (32 women and 20 men) and 44 anterior cruciate ligament-injured cases (23 women and 21 men) were measured using magnetic resonance images and 3-d image reconstruction using commercial software Analyze 9.0. We hypothesized that the Individuals with a small tibial eminence are at increased risk of suffering an anterior cruciate ligament injury compared with those with larger tibial eminences. Based on t-tests, we established that the uninjured controls had larger tibial eminences (p<0.05) compared with the injured cases. Biomechanically speaking a larger tibial eminence could prevent excessive medio-lateral movement of femur with respect to the tibia. A larger eminence could also protect the knee from large magnitude rotational movements. We suggest that future studies are needed to confirm this relationship and to evaluate the potential role of the tibial eminence size in the risk of ACL injury.

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