An association between femoral trochlear morphology and non-contact anterior cruciate ligament total rupture: a retrospective MRI study

Işiklar, Sefa; Ozdemir, Senem Turan; Gökalp, Gökhan

doi:10.1007/s00256-020-03706-3

Cited by 9 publications

(6 citation statements)

References 37 publications

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“…The statistical power attained was 95.4%. Notably, previous studies aimed at a power of 80%, [ 14 , 16 , 17 ] underscoring the robustness of the statistical power achieved in this study (95.4%).…”

Section: Methodssupporting

confidence: 75%

“…1). [14] Two independent observers, with no knowledge of the patient 's medical history, measured the aforementioned parameters of the femoral trochlea. Repeated measurements were performed 2 weeks later, and the intra-observer reliability and inter-observer reliability calculated using the intra-class correlation method were 0.85 and 0.93, respectively.…”

Section: Measurement Methodsmentioning

confidence: 99%

“…Morphological parameters of the femoral trochlea were measured on the largest axial image of the femoral condyle and trochlea. [ 14 , 15 ] First, the posterior condylar axis: the connection between the 2 points of the posterior femoral condyle was determined in the axial direction of the femoral condyle. Medial condylar height (MCH), trochlear sulcus height (TSH), and lateral condylar height (LCH) were determined perpendicular to the posterior condylar line.…”

Section: Methodsmentioning

confidence: 99%

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Abnormal femoral trochlea morphology is a risk factor for secondary injury of anterior cruciate ligament after reconstruction

Cai,

Wang,,

Yan

et al. 2024

Medicine

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Secondary injury of the anterior cruciate ligament (ACL) is a common concern after anterior cruciate ligament (ACL) reconstruction, and identification of morphological risk factors is essential to prevent these injuries. We hypothesized that abnormal femoral trochlea morphology is associated with secondary ACL injuries after reconstruction. This study aimed to investigate the relationship between femoral trochlear morphology and secondary ACL injuries after reconstruction. A retrospective analysis was conducted on 20 patients who experienced secondary ACL injuries after reconstruction in our hospital between 2017 and 2022 (experimental group), and 40 patients were included in the control group. The following femoral trochlear characteristics were compared between the 2 groups: medial condylar height (MCH), trochlear sulcus height (TSH), lateral condylar height (LCH), trochlear sulcus depth (TSD), trochlear sulcus angle (TSA), medial trochlear inclination (MTI), and lateral trochlear inclination (LTI). The study found that patients in the secondary ACL injury after reconstruction group exhibited the following differences when compared to the control group: decreased MCH (56.33 ± 3.52 vs 59.93 ± 3.24, P value = .015), decreased TSD (4.89 ± 1.56 vs 6.98 ± 1.23, P value ˂ .001), decreased MTI (12.54 ± 6.57 vs 19.45 ± 6.35, P value ˂ .001), and increased TSA (145.23 ± 9.76 vs 139.25 ± 8.42, P value ˂ .001). This study demonstrated a significant correlation between abnormal femoral trochlear morphological characteristics and secondary ACL injuries after reconstruction. Decreased MCH, TSD, and MTI along with increased TSA are associated with a higher risk of secondary ACL injury. These data could thus help identify individuals susceptible to secondary ACL injuries after reconstruction.

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Section: Methodssupporting

confidence: 75%

Section: Measurement Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Abnormal femoral trochlea morphology is a risk factor for secondary injury of anterior cruciate ligament after reconstruction

Cai,

Wang,,

Yan

et al. 2024

Medicine

View full text Add to dashboard Cite

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“…27 Previous studies have reported bone morphology-related risk factors associated with noncontact ACL injuries. 8,14,17,21,24 Regarding studies that reported these risk factors for contact ACL injuries, DePhillipo et al 7 found that the PTS increased significantly among patients with contact ACL tears as compared with controls. In the present study, the PTS did not differ between the control and contact groups.…”

Section: Discussionmentioning

confidence: 99%

Bone Morphological Characteristics as Risk Factors for Anterior Cruciate Ligament Injury: Comparison Between Contact and Noncontact Injury

Choi

Lee

Victoroff

2023

Orthopaedic Journal of Sports Medicine

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Background: Altered bone morphologies are considered risk factors for noncontact anterior cruciate ligament (ACL) injuries. Purpose/Hypothesis: This study aimed to investigate bone morphological characteristics as risk factors for ACL tears in contact injuries and compare these factors with those for noncontact ACL injuries. We hypothesized that altered bone morphologies would also be risk factors for contact ACL injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Enrolled were patients who underwent primary ACL reconstructions between January 2000 and December 2021 within 6 weeks after injury. Patients in the ACL group were classified according to injury mechanism (contact vs noncontact). During the same period, a control group of patients matched by age, height, and body mass index to the ACL group was selected. The lateral femoral condylar ratio (LFCR), notch width index (NWI), and lateral posterior tibial slope (PTS) were measured. Measured parameters were compared between the control, contact, and noncontact groups using analysis of variance. Results: There were 86 patients in the control group, 102 patients in the contact ACL group, and 105 patients in the noncontact ACL group. The demographic characteristics of the 3 groups did not differ significantly. The contact group had significantly higher LFCRs and lower NWIs compared with the control group ( P < .001 and P = .001, respectively). The noncontact group had significantly higher LFCRs and PTSs and lower NWIs compared with the control group ( P = .031; P < .001; and P < .001, respectively). The noncontact group had significantly higher PTSs and lower NWIs compared with the contact group ( P = .003 and P =.014, respectively). In the contact group, the LFCR, PTS, and NWI were significant risk factors for ACL tears (odds ratio [OR], 1.25 [ P < .001]; OR, 1.16 [ P = .008]; and OR, 1.27 [ P = .001], respectively), and in the noncontact group, the PTS and NWI were significant risk factors for ACL tears (OR, 1.20 [ P < .001]; OR, 1.59 [ P < .001], respectively). Conclusion: Altered bone morphological characteristics of the knee were found to be risk factors for ACL tears in contact injuries as well as noncontact injuries. Altered morphology has a more significant effect in noncontact ACL injuries.

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“…A previous study reported that 96% of patients with PI had trochlear dysplasia, which is an abnormality of the shape and depth of the trochlear groove [ 34 , 35 ]. Isıklar et al [ 36 ] observed that mild trochlear dysplasia caused intercondylar notch stenosis instead of changes of the patellar localization, indicating that dysplasia in the anterior distal femur may cause notch stenosis in the posterior distal femur. Patients with trochlear dysplasia also had different posterior femoral condyles, characterized by a smaller lateral posterior condyle and a bigger medial posterior condyle [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

The patient with patellar instability has a stenotic intercondylar notch and a thin anterior cruciate ligament: a retrospective comparative study

et al. 2023

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Background Patellar instability (PI) usually combines with morphological abnormalities of femoral condyles that may affect the morphology of the intercondylar notch and anterior cruciate ligament (ACL), which are important in individualized ACL reconstruction. This study aimed to investigate the morphological characteristics of the intercondylar notch and ACL in patients with PI. Methods 80 patients with PI and 160 age- and gender-matched controls from January 2014 to June 2022 were studied. Morphological measurements of the femoral condyles included intercondylar notch height, notch width, medial condylar width, lateral condylar width, bicondylar width, notch width index, notch angle, lateral femoral condyle ratio (LFCR), condyle flexion angle, and posterior tibial slope. Morphological measurements of the ACL included ACL length, inclination angle, and ACL size. The measurements were compared between PI and control groups, and between males and females in PI group. The independent samples t-test was performed to examine differences in continuous variables. The chi-square test was used for comparing categorical variables. Results The intercondylar notch width, bicondylar width, notch width index, and notch angle were significantly smaller, while the LFCR was significantly larger in PI group than those of control group (p < 0.05). The ACL thickness (0.70 ± 0.16 cm vs 0.80 ± 0.21 cm, p = 0.023) and width (0.54 ± 0.14 cm vs 0.60 ± 0.13 cm, p = 0.029) were significantly smaller in PI group. The notch width was significantly smaller in female patients than males in PI group, but no significant difference was observed in the notch width index and notch angle (p > 0.05). No sex difference related to the morphology of the ACL was found. Conclusions The patient with PI had a stenotic intercondylar notch and a thin ACL. No significant sex difference in the intercondylar notch stenosis and ACL size was observed. The morphology of the intercondylar notch and ACL should be taken into consideration when planning individualized ACL reconstruction in the presence of PI.

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An association between femoral trochlear morphology and non-contact anterior cruciate ligament total rupture: a retrospective MRI study

Cited by 9 publications

References 37 publications

Abnormal femoral trochlea morphology is a risk factor for secondary injury of anterior cruciate ligament after reconstruction

Abnormal femoral trochlea morphology is a risk factor for secondary injury of anterior cruciate ligament after reconstruction

Bone Morphological Characteristics as Risk Factors for Anterior Cruciate Ligament Injury: Comparison Between Contact and Noncontact Injury

The patient with patellar instability has a stenotic intercondylar notch and a thin anterior cruciate ligament: a retrospective comparative study

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