The Effect of the Intercondylar Notch Shape and Notch Width Index on Anterior Cruciate Ligament Injuries

Basukala, Bibek; Joshi, Amit; Pradhan, Ishor

doi:10.33314/jnhrc.v17i4.1858

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Bhasukala et al, showed NWI to be 0.28 ± 0.06. 21 However, GormeliCA et al showed cut-off values of NWI of 0.22 ± 0.008 in bilateral injured knees and 0.24 ± 0.01 in the unilateral injured knee (18). Another study by, Hirtlet et al, showed NWI at the level of Popliteal groove to be 0.25± 0.03.…”

Section: Discussionmentioning

confidence: 99%

The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width, notch width index, notch shape - A randomized control study

Fahim

Dhawan

Jagadeesh

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Background: ACL injuries are infamously known for disability in young adults and require surgical reconstruction. The need of time is to predict predisposing factors and prevent ACL injuries.The incidence of ACL injuries has been associated with various factors related to the morphology of distal femur and proximal tibia.Hence, purpose of this study was to assess the relationship of morphology of distal femur by assessing Notch Width(NW), Notch Width Index (NWI), and Notch shape calculated preoperatively on MRI in association with an ACL tear. Methods: The following randomized control study had 60 patients enrolled with non contact injury to knee who were equally divided into 2 groups i.e. ACL injury group and control group. ACL group had patients who had MRI proven ACL tear along with clinical findings suggestive of ACL tear whereas control contained patients with intact ACL. Demographic data was collected and NW, NWI and Notch shape were determined on coronal sections of MRI sequences. Results: Positive correlation of ACL tear was seen with NW, BCW, NWI, NWP, and NWJ. Smaller Notch Width showed higher incidence of ACL tear (p ¼ 0.019). The mean NWI in the injured and control knee is 0.31 ± 0.01 and 0.27 ± 0.01 respectively and was statistically significant(p < 0.001). A shaped Notch (60%) was commonly seen in ACL tear group and U shaped notch (73.3%) was commonly seen in control group.We found the cut off value for the prediction of ACL tear of NWI was 0.29 with a sensitivity of 90% and specificity of 86.7%. Conclusion: ACL injuries in the given population have shown higher incidence with narrow femoral intercondylar notch, smaller notch width index, 'A' shaped femoral notch. If any of the above findings are present in the MRI, its important to counsel the subjects about the increased risk of ACL injuries in them and take preventive measures.

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Section: Discussionmentioning

confidence: 99%

The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width, notch width index, notch shape - A randomized control study

Fahim

Dhawan

Jagadeesh

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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“…In order to identify the strongest MRI predictors and construct a credible and convenient risk prediction model for ACL injury, other existing bone morphological risk factors were also performed: medial tibial slope (MTS) ( Elmansori et al, 2017 ; Schneider et al, 2020 ), lateral tibial slope (LTS) ( Kumar et al, 2020 ), medial tibial depth (MTD) ( Misir et al, 2022 ), lateral tibial height (LTH) ( Kujala et al, 1992 ) and notch width index (NWI) ( Basukala et al, 2020 ; Bouras et al, 2018 ) ( Figure 3 ). To evaluate the intraobserver reliability, one observer measured LFCRs in 50 patients randomly selected from the entire cohort and performed the same measurements again 2 weeks later.…”

Section: Methodsmentioning

confidence: 99%

The relationship between lateral femoral condyle ratio measured by MRI and anterior cruciate ligament injury

Sun,

Tang

2024

Front. Bioeng. Biotechnol.

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Background:Previous studies have shown that the lateral femoral condyle ratio (LFCR) measured by X-ray has a significant relationship with the anterior cruciate ligament (ACL) injury. However, few relevant studies have been performed on LFCR measured by magnetic resonance imaging (MRI).Purpose:(1) To evaluate the relationship between LFCR measured by MRI and ACL injury or rerupture. (2) To compare the LFCR measured by MRI with existing bony morphological risk factors and screen out the most predictive risk factors for primary ACL injury or rerupture.Study Design:Cohort study; Level of evidence, 3.Methods:Totally 147 patients who underwent knee arthroscopic surgery from 2015 to 2019 with minimum follow-up of 48 months were retrospectively evaluated. Patients were placed into three groups: 1) the control group of patients with simple meniscus tears without ligament injury; 2) the primary noncontact ACL injury group; 3) ACL rerupture group (ACL reconstruction failure). The LFCR measured by MRI and other previous known risk factors associated with MRI (notch width index, medial tibial slope, lateral tibial slope, medial tibial depth, lateral tibial height) were performed to evaluate their predictive value for ACL injury and rerupture. All the risk factors with p < 0.01 according to univariate analysis were included in the logistic regression models. Receiver operating characteristic (ROC) curves were analyzed for sensitivity, specificity, cut-off, and area under the curve (AUC). Z tests were used to compare the AUC values.Results:The LFCR measured by MRI was obviously higher in primary ACL injury group (0.628 ± 0.020) and in ACL rerupture group (0.625 ± 0.021) than that in the control group (0.593 ± 0.030). The best risk factor was the LFCR with a cut-off of 0.602 (AUC, 0.818; 95% CI, 0.748–0.878; sensitivity, 90%; specificity, 66%). When combined with lateral tibial slope (cutoff, 7°) and lateral tibial height (cutoff, 3.6 mm), the diagnostic performance was improved significantly (AUC, 0.896; 95% CI, 0.890–0.950; sensitivity, 87%; specificity, 80%).Conclusion:The increased LFCR measured by MRI was associated with a significantly higher risk for ACL injury or rerupture. The combination of LFCR, lateral tibial slope and lateral tibial height were the most predictive risk factors. This may help clinicians identify susceptible individuals and allow precision approaches for better prevention, treatment and management of this disease.

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“…Fahim Et all reported cut off value of 0.29 with a sensitivity of 90% and specificity of 86.7%. However, Gormeli CA et al In their study on bilateral knees with ACL injury demonstrated cut-off values of NWI of 0.22 ± 0.008 in bilateral injured knees and 0.24 ± 0.01 in the unilateral injured knee [29][30][31]. So the cut off varies depending on the ethnicity and the exact cutoff values are still controversial but most authors have concluded the critical value NWI ranging from 0.19 to 0.26.…”

Section: Notch Parametersmentioning

confidence: 99%

“…If NWP < NWJ then the notch is of "A" shape.If the NWP > NWJ then the notch shape is of Omega shape. 'A' shaped femoral notch is commonly associated with ACL injury whereas an inverted U shaped notch is more favourable to prevent ACL injury [29,30,35].…”

Section: Notch Parametersmentioning

confidence: 99%

Risk Factors of ACL Injury

Jagadeesh¹,

Kapadi²,

Deva³

et al. 2022

Arthroscopy

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An anterior cruciate ligament(ACL) is one of the major stabilizers of the knee joint, injury to which can be quite dreadful even ending many sports careers if not properly treated. Knowledge of the risk factors contributing to ACL injury will help in identifying at-risk individuals and develop preventive strategies. The factors contributing to ACL injury are multi-factorial involving biomechanical, anatomical, hormonal, neuromuscular factors etc; and can be broadly classified as Intrinsic and Extrinsic factors. Intrinsic factors are mostly non-modifiable risk factors may be subdivided into anatomical, genetic, gender, previous ACL Injuries etc . Whereas Extrinsic factors are mostly modifiable risk factors include environmental factors, characteristic of surface and shoe, BMI and others. Anatomical risk factors can divided into tibial parameters like posterior tibial slope, medial tibial plateau depth etc ; femoral parameters like notch width, notch index etc.

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The Effect of the Intercondylar Notch Shape and Notch Width Index on Anterior Cruciate Ligament Injuries

Cited by 4 publications

References 8 publications

The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width, notch width index, notch shape - A randomized control study

The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width, notch width index, notch shape - A randomized control study

The relationship between lateral femoral condyle ratio measured by MRI and anterior cruciate ligament injury

Risk Factors of ACL Injury

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