Notch Volume Measured on Magnetic Resonance Imaging Is Better Than 2-Dimensional Notch Parameters for Predicting Noncontact Anterior Cruciate Ligament Injury in Males

Jha, Vivek; Pandit, Abhishek

doi:10.1016/j.arthro.2020.11.050

Cited by 7 publications

(11 citation statements)

References 48 publications

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“…The intercondylar notch angle was measured between 2 lines drawn from the highest point of the femoral notch to the medial and lateral margins of the intercondylar notch 1 3 (Fig. 1b, c) [11,21]. The NWI is the ratio of the intercondylar notch width to the femoral condylar width.…”

Section: Methodsmentioning

confidence: 99%

Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Liu

Zhang

Xiao

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The present study aimed to examine the factors related to the morphological characteristics of the femoral condyle in posterior cruciate ligament rupture in female and male populations. Methods One hundred and three patients (41 females, 62 males) with posterior cruciate ligament rupture from 2010 to 2020 were included in this retrospective case–control study. The sex and age of the posterior cruciate ligament rupture group were matched to those of the control group (41 females, 62 males; age range 16–69 years). Magnetic resonance imaging was used to measure the intercondylar notch width, femoral condylar width, and intercondylar notch angle in both the axial and coronal images. The ‘α’ angle was also measured using magnetic resonance imaging. The notch width index is the ratio of the intercondylar notch width to the femoral condylar width. Three types of intercondylar notch shapes (types A, U, and W) were evaluated in the axial magnetic resonance imaging images. Results The difference in the mean coronal notch width index between the study groups was statistically significant in the female population. The difference in the mean coronal femoral condylar width between the study groups was statistically significant in the male population. Conclusions A larger coronal notch width index was the greatest risk factor for posterior cruciate ligament rupture in the female population. In the male population, decreased coronal condylar width was the greatest risk factor for posterior cruciate ligament rupture. The results did not indicate that patients with a PCL rupture have a stenotic intercondylar notch. Posterior cruciate ligament injury prevention strategies could be applied to females with a larger coronal notch width index and males with a decreased condylar width. Levels of evidence Level III.

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Section: Methodsmentioning

confidence: 99%

Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Liu

Zhang

Xiao

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…The literature search identified 328 articles and a detailed screening process ( Fig. 1 ) yielded 12 studies 14 21 22 23 24 32 33 34 35 36 37 38) that qualified for the study. Three studies were from the same authors/institutions and had overlapping duration of the study.…”

Section: Resultsmentioning

confidence: 99%

“…All included studies were case-control in design and 6 22 23 24 33 36 37) of those contained sex-related data. One study was exclusively limited to men.…”

Section: Resultsmentioning

confidence: 99%

“… 33) With regards to moderator characteristics that were decided a priori, 5 studies included only non-contact ACL injuries, 14 23 33 34 36) while the others 22 24 32 35 37) were unrestricted/unspecified. The most common method of measurement (6 studies) 22 23 24 35 36 37) was on axial MRI sections as per Charlton et al 25) One study 33) modified the method by including a slice interval, while 3 studies 14 32 34) used different methods. Five studies had matching of controls, 14 22 23 33 36) while the other 5 24 32 34 35 37) had unmatched selection of controls.…”

Section: Resultsmentioning

confidence: 99%

“…The most common method of measurement (6 studies) 22 23 24 35 36 37) was on axial MRI sections as per Charlton et al 25) One study 33) modified the method by including a slice interval, while 3 studies 14 32 34) used different methods. Five studies had matching of controls, 14 22 23 33 36) while the other 5 24 32 34 35 37) had unmatched selection of controls. Contralateral healthy knees were used as a surrogate for measurements of the injured knees in 3 studies 14 35 36) (primarily because of interest in the pre-injury status of ACL volume), while the rest (7 studies) 22 23 24 32 33 34 37) used the injured knees.…”

Section: Resultsmentioning

confidence: 99%

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Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured?: A Meta-Analysis

et al. 2022

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Background Stenotic femoral intercondylar notch is considered as a risk factor for anterior cruciate ligament (ACL) injury and three-dimensional notch volume is used as a marker for the injury. The primary purpose of this study was to assess the difference in notch volume between the ACL-injured and uninjured in men and women combined or stratified by sex. The secondary purpose was to assess the difference in notch volume between the ACL-intact men and women. Methods A search of PubMed/Medline, Scopus, Google Scholar, and Cochrane databases from inception to December 9, 2020, was conducted without restrictions using the following terms: ACL, notch, volume, notch volume, femoral notch volume, and intercondylar notch volume. Studies that compared the ACL-injured with uninjured controls were included. Independent extraction of articles by two authors using predefined data fields including study quality indicators was done. All pooled analyses were based on the inverse-variance weighted random effects model and mean difference was chosen as the effect measure. Results Nine studies (1,169 knees) qualified for overall analysis (both sexes combined) and significant heterogeneity was observed, which disappeared after pooling studies with age-sex matched controls and those without. Notch volume in the ACL-injured was 0.75 cm 3 (95% confidence interval [CI], 0.53–0.96 cm 3 ), which was smaller than that in the age- and sex-matched controls. Six studies qualified for analysis in men. Notch volume in the ACL-injured men was smaller, especially when non-contact ACL injury was considered (1.40 cm 3 ; 95% CI, 1.08–1.73 cm 3 ). Five studies qualified for analysis in women and ACL-injured women had smaller notch volume irrespective of the mechanism of injury (0.38 cm 3 ; 95% CI, 0.18–0.59 cm 3 ). Notch volume of the uninjured men was larger than that of the uninjured women (1.86 cm 3 ; 95% CI, 1.54–2.18 cm 3 ). Conclusions ACL-injured adults have smaller notch volume than the age- and sex-matched controls. Non-contact ACL-injured males have smaller notch volume compared to ACL-intact males. ACL-injured females have smaller notch volume irrespective of the nature of injury. Men have higher notch volume than women. The quality of evidence is very low to low.

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The intercondylar fossa—A narrative review

2021

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The intercondylar fossa ("intercondylar notch," IN) is a groove at the distal end of the femur, housing important stabilizing structures: cruciate ligaments and meniscofemoral ligaments. As the risk for injury to these structures correlates with changes to the IN, exact knowledge of its morphology, possible physiological and pathological changes and different approaches for evaluating it are important. The divergent ways of assessing the IN and the corresponding measurement methods have led to various descriptions of its possible shapes. Ridges at the medial and lateral wall are considered clinically important because they can help with orientation during arthroscopy, whereas ridges at the osteochondral border could affect the risk of ligament injury. Changes related to aging and sex differences have been documented, further emphasizing the importance of individual assessment of the knee joint. Overall, it is of the utmost importance to remember the interactions between the osseous housing and the structures within.

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Notch Volume Measured on Magnetic Resonance Imaging Is Better Than 2-Dimensional Notch Parameters for Predicting Noncontact Anterior Cruciate Ligament Injury in Males

Cited by 7 publications

References 48 publications

Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging

Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured?: A Meta-Analysis

The intercondylar fossa—A narrative review

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