Lower Limb Alignment in Anterior Cruciate Ligament–Deficient versus –Intact Knees

Abstract

Small notch width was associated with a thin ACL and can be regarded as an anatomic intrinsic risk factor for ACL injuries.

Notch morphology is a risk factor for ACL injury: a systematic review and meta-analysis

“…Furthermore, Şenişik et al 26 added that participants had an increased posterior tibial slope in their ACL-injured leg when compared to the contralateral one, and that participants with a posterior tibial slope >9.57° would have a nearly sixfold increased risk of ACL injury. Conversely, Chung et al 22 reported no significant differences on the posterior tibial slope between ACL-deficient and ACL-intact knees.…”

“…Seven studies10 11 14 16 17 20 22 showed that a narrower ICN correlated with a higher risk of ACL injury (table 4). Conversely, Alentorn-Geli et al ,19 Stijak et al 7 and Lombardo et al 18 found no significant difference on ICN width between ACL-injured and non-ACL-injured participants.…”

“…We pooled the results regarding the measurements of the tibial slope,8 17 21 22 24 26–28 subgrouping them into posterior, medial and lateral tibial slope. The test for heterogeneity showed that there was moderate heterogeneity for the overall effect (I 2 =54%; p=0.03) but no heterogeneity for the subgroup differences (I 2 =0%; p=0.87).…”

“…The scientific literature describes many predisposing factors for ACL injury, including biomechanical, functional, anatomical and morphological factors. The bony anatomical and morphological parameters described in the scientific literature focus primarily on the femoral intercondylar notch (ICN) and femoral condyles’ shape and dimensions,7–20 notch width index (NWI)8–10 12 14 18 19 21–23 and tibial slopes 8 17 19 21 22 24–29. The pathological association between the ICN and the ACL was first described by Palmer,30 in 1938, when he noticed, as the knee was flexed and supinated, that the ACL was placed in a vulnerable position by being stretched over the inner margin of the lateral femoral condyle.…”

Is posterior tibial slope associated with noncontact anterior cruciate ligament injury?

“…slope was associated with ACL tear [5,13,40,43,44,46]; on the contrary, others rejected this correlation [4,8,15,17,18,39,42]. Moreover, there exist two metaanalyses came to totally opposite conclusions [48,49].…”