Influence of morphometric intercondylar notch parameters in ACL ruptures

Abstract

The most important anatomic risk factors in ACL lesions are the morphometric parameters of intercondylar notch. In the morphometric studies index of notch width and index of notch shape (NWI and NSI) are commonly used. The certain morphologic parameters of distal femoral part are used in calculation. Beside standard parameters we measured the maximal width of intercondylar notch and distal part of femur, which we used for calculation of maximal index of notch width and maximal index of notch shape (NWI max and NSI max). We compared two different methods of calculation of intercondylar notch indexes to find out which one represent anatomic risk factor and influence the ACL lesions. The indexes were measured in the two groups of patients (33) who have the history of knee injuries, the first group has document of ACL injuries and the second without ACL injuries (control one). The important difference between two groups was founded in NWI (p < 0.01) and NSI (p < 0.05). NWImax and NSImax do not show the difference (p > 0.05). The NWI and NSI importance is higher in males, and smaller in females. There is no difference in NWImax and NSImax (p > 0.05) comparing to the gender.

The Importance of the Intercondylar Notch in Anterior Cruciate Ligament Tears

“… 8 , 11 In fact, the clinical relevance of the intercondylar notch was recognized by Fu and Musahl, 11 who developed a mathematical model to quantitatively characterize impingement of the ACL against the intercondylar notch in 3-dimensional (3D) space. Stijak et al 18 stated that the most important anatomic risk factors in ACL tears are the morphometric parameters of the intercondylar notch. In morphometric studies, the index of notch width and the index of notch shape (NWI and NSI, respectively) are commonly used.…”

Correlation between Trochlear Dysplasia and the Notch Index

“…25 Notch stenosis is associated with increased mucoid hypertrophy and ACL injuries, especially in those who participate in non-contact sports. 9,12 On the contrary, there is no correlation between notch stenosis and ACL injuries in basketball players, 26 and ACL injuries are associated with a larger notch. 8 The notch is larger in males and depends on patient weight and height.…”

“…22 The morphology of the notch and trochlea is associated with ACL injuries. 10,12 At the notch outlet, the mean notch width is about 18.5 mm in females and 21.4 mm in males. 7 The notch index is a ratio of the notch width to the intercondylar width.…”

“…[3][4][5] Knees with a narrow notch (decreased notch index) are associated with a higher risk of cruciate ligament injury. [6][7][8][9][10][11][12][13][14][15][16] This study evaluated the correlation between trochlear dysplasia and the notch index.…”

The position of anterior cuciate ligament in frontal and sagittal plane

“…Oblik interkondilarne jame mo'e da odigra zna~ajnu ulogu u povredjivanju prednje ukr{tene veze. 6 Su'ena interkondilarna jama, odnosno, isuvi{e strma unutra{nja strana lateralnog femoralnog kondila smanjuje popre~ni presek interkondilarne jame i mo'e da dovede do oslanjanja prednje ukr{tene veze na spolja{nji kondil butne kosti, trenja a zatim rupture prednje ukr{tene veze ili transplantiranog grafta. Shepstone i sar 7 Iako su se mnoge studije bavile povezivanjem oblika interkondilarne jame sa povredjivanjem prednje ukr{tene veze, malo njih je izu~avalo ugao pod kojim se prednja ukr{tena veza pripaja na unutra{nju stranu spolja{njeg femoralnog kondila.…”