Anatomical Risk Factors for Rupture of the Anterior Cruciate Ligament: Magnetic Resonance Imaging Based Knee Joint Assessment

Abstract

Anterior cruciate ligament (ACL) rupture is one of the most frequently encountered traumatic ligamentous lesions of the knee. Several intrinsic and extrinsic factors are linked to this lesion. Anatomical factors increase the anterior translation of the knee and thus promote the stretching and rupture of the anterior cruciate ligament. Objectives: To determine the anatomical risk factors favouring ACL rupture by comparing morphometric parameters of patients with knee ACL rupture to patients without ACL rupture, as well as the intercondylar notch index and the tibial slopes of the two groups and describing the ruptured ACLs and associated signs. Materials and Methods: We conducted a case-control descriptive analytical study in imaging centres of the General Henri Mondor of Aurillac Hospital Centre in France (CHM) and the Jordan Medical Centre of Yaoundé in Cameroon (CMJ). MRI exam protocols included T1 SE, T2 SE, proton density and Fat Sat sequences, with slices in all three planes. Morphometry knee variables measured in our study were: intercondylar notch index and the tibial slopes. These measurements were obtained from images stored in DICOM format and post processing software OsiriX MD ® for CMJ patients and Explore ® for CHM patients. Results: The study included 92 individuals, 38 in the case group and 54 in the control group. The mean age was 36.6 years for both groups; 35.5 years for the cases and 37.4 years for the controls. The sex ratio was 1.87 men for 1 woman in

Profile of Knee MRI Morphometric Risk Factors for Anterior Cruciate Ligament Tear at Dr. Soetomo General Academic Hospital

“…This finding is consistent with previous studies from Prince et al and Zeh et al, which stated that in immature (young) skeletal group, ACL tear in men, avulsion fractures, and partial tears were more likely to be found. 11,21 However, this finding was inconsistence with a study from Bayer et al, which stated that the risk of ACL tear was three to six times greater in women compared to men. 10 This could be due to the fact that men have more external predisposing factors, and in this study the number men samples was higher compared to women samples.…”

“…According to previous studies from Zeh et al and Shen et al, ACL tear incidence was most common in the 3 rd decade of life. 11,15 This could be caused by high activity in this age group, both risky activities such as sports that require a lot of jumping, landing or sudden changes in position, as well as general activities but with a high risk of contact trauma. 8 The most common secondary or indirect sign found in this study was PCL buckling, which is an abnormal orientation of the PCL, for totalACLtear and bone contusion for partial ACL tear.…”

“…In addition, a greater force is needed for causing the tibia and femur bone to collide with each other and bone contusion to occur. 11,15,[21][22][23] Another cause is the undetermined period of time between ACL tear incidence and MRI examination, therefore when an MRI examination was performed, bone contusion finding have disappeared.…”

“…Identification of these risk factors in athletes will be useful to adjust the type of training for each individual according to their anatomical variation for minimizing ACL tear incidence. 1,7,[9][10][11][12][13][14] Previous study reported that anatomical factors that play some roles in ACL tear were femurotibial alignment, narrow intercondylar notch, type A stenotic notch, medial tibial plate depth, and steep lateral tibial slope. However, various measurement techniques and methods of these anatomical factors are still debatable.…”

“…However, various measurement techniques and methods of these anatomical factors are still debatable. 1,2,[9][10][11]13,[15][16][17]18 This study aims to provide an overview of anatomical risk factor characteristics in knee joint MRI study.…”