Increased lateral femoral condyle ratio is associated with greater risk of ALC injury in non-contact anterior cruciate l
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Increased lateral femoral condyle ratio is associated with greater risk of ALC injury in non‑contact anterior cruciate ligament injury Ke Li1 · Xiaoqing Zheng4 · Jia Li3 · Rebecca A. Seeley6 · Vincent Marot2 · Jérôme Murgier5 · Xi Liang1 · Wei Huang1 · Etienne Cavaignac2 Received: 6 February 2020 / Accepted: 26 October 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose To examine whether increased lateral femoral condyle ratio (LFCR) correlates with increased risk of Anterior cruciate ligament (ACL) injury (1) and to evaluate the relationship between the LFCR and anterolateral complex (ALC) injury in non-contact ACL torn knees (2). Methods Six hundred and seventy-two patients who underwent ACL reconstruction surgery between 2013 and 2019 were retrospectively reviewed, and 120 patients were finally included in the study. Forty patients (ACL + ALC injury) were included in the study group, while forty patients with isolated ACL injury (isolated ACL injury group) and 40 patients who suffered from meniscal tear without ACL or ALC injury were matched in a 1:1 fashion by age, sex, and BMI to the study group (ACL + ALC injury). The LFCR was measured on standard lateral radiographs in a blinded fashion. The differences between the three groups were analyzed by ANOVA. A ROC (Receiver Operating Characteristic) curve was produced to determine risk of ACL injury and risk of concomitant ALC injury in non-contact ACL injury. Results The mean LFCR was 71.9% ± 3.1% in the ACL + ALC injury group, 68.4% ± 3.2% in the isolated ACL injury group, and 66.8% ± 2.6% in the control group (patients who suffered from meniscal tear without ACL or ALC injury). Significantly greater LFCR was found in the ACL + ALC injury group than that in the isolated ACL injury group (p 69.4% was predictive for an increased risk of ALC injury in non-contact ACL ruptured patients. Conclusion Increased LFCR was found to be associated with greater risk of ALC injury in non-contact ACL ruptured patients. Additionally, increased LFCR was further confirmed to be correlated with increased risk of ACL injury in an Asian population. The data from this study may help recognize patients undergoing ACL reconstruction that could benefit from additional extra-articular tenodesis. Level of evidence III. Keywords ACL injury · Anterolateral complex · Lateral femoral condyle ratio · Rotatory instability
Introduction
Ke Li and Xiaoqing Zheng authors have contribute equally to this work. This work was performed in Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University. * Ke Li [email protected] Extended author information available on the last page of the article
Previous studies have proposed different risk factors and associated findings regarding ACL injuries, including: BMI, gender, general joint laxity, and ipsilateral ACL injuries [1–7]. Some morphological differences, including increased posterior tibial slope and decreased notch width of the distal femur, have
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