The occurrence of ACL injury influenced by the variance in width between the tibial spine and the femoral intercondylar
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The occurrence of ACL injury influenced by the variance in width between the tibial spine and the femoral intercondylar notch Takanori Iriuchishima1 · Bunsei Goto1 · Freddie H. Fu2 Received: 22 January 2020 / Accepted: 23 March 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose The purpose of this study was to reveal the influence of the variance in width between the tibial spine and the femoral intercondylar notch on the occurrence of ACL injury. Methods Thirty-nine subjects undergoing anatomical ACL reconstruction (30 female, 9 male; average age 29 ± 15.2) and 37 subjects with intact ACL (21 female, 16 male; average age 29 ± 12.5) were included in this study. In the anterior–posterior knee radiograph, tibial spine height, and the length between the top of the medial and lateral tibial spine (tibial spine width) were measured. In axial knee MRI exhibiting the longest femoral epicondylar length, intercondylar notch outlet length was measured and notch width index was calculated. Tibial spine width/notch outlet length, and tibial spine width/notch width index were compared between the ACL tear and intact groups. Results Tibial spine width/notch outlet length of the ACL tear and intact groups was 0.6 ± 0.1 and 0.7 ± 0.1, respectively. Tibial spine width/notch width index of the ACL tear and intact groups was 0.4 ± 0.1, and 0.6 ± 0.1, respectively. Both parameters were significantly larger in the ACL intact group. Conclusion Both tibial spine width/notch outlet length and tibial spine width/notch width index were significantly smaller in the ACL tear group when compared with the ACL intact group. The occurrence of ACL injury influenced by the variance in width between the tibial spine and the femoral intercondylar notch. Level of evidence III. Keywords Anterior cruciate ligament · Anatomy · Tibia · Tibial spine Abbreviation ACL Anterior cruciate ligament
Introduction Anterior cruciate ligament (ACL) tear mainly occurs during sports activity which requires jumping, turning, and cutting motions [6, 11, 13, 16, 17]. Many factors such as joint laxity, weak muscle strength in the lower extremities, and knee balance during landing have been reported to be correlated with the occurrence of ACL injury [20, 21, 24, 31–33]. In addition to these risk factors concerning body morphology * Takanori Iriuchishima [email protected] 1
Department of Orthopaedic Surgery, Kamimoku Spa Hospital, Minakami, Japan
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
2
or motion abnormalities [3, 12, 30], it has been reported that knees in which ACL tear occur have common morphological characteristics [7, 9, 10, 15, 18, 20, 30]. On the femoral side, several studies have reported that the intercondylar notch shape is correlated with the occurrence of ACL injury [5, 28, 29]. On the tibial side, the articular geometry of the tibia plateau has been studied in detail [8, 12, 18, 20, 23, 26, 29]. Posterior tibial slope has also been reveal
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