Correlation of intercondylar notch cross sections to the ACL size: a high resolution MR tomographic in vivo analysis

Dienst, Michael; Schneider, Guenther; Altmeyer, K.; Voelkering, Kristina; Georg, Thomas; Kramann, B.; Kohn, Dieter

doi:10.1007/s00402-006-0177-7

Cited by 128 publications

(141 citation statements)

References 24 publications

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“…Established anatomic risk factors for human ACL injury were measured using the MR image stack, including ACL size (length, cross-sectional area and volume) [13,18,32], medial femoral and tibial cartilage thickness [11,12], posterior slope of the tibial plateau in the medial and lateral compartments [24,25], and intercondylar notch size (width, area, and index) [3]. The bicondylar width also was quantified as a measure of overall knee size [58].…”

Section: Anatomic Indices Measurementmentioning

confidence: 99%

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Validation of Porcine Knee as a Sex-specific Model to Study Human Anterior Cruciate Ligament Disorders

Kiapour

Shalvoy

Murray

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Animal models have long been considered an important modality for studying ACL injuries. However, to our knowledge, the value of these preclinical models to study sex-related phenomena associated with ACL injury and recovery has not been evaluated. Questions/purposesWe asked whether (1) prominent anatomic and (2) biomechanical factors differ between female and male porcine knees, particularly those known to increase the risk of ACL injury. Methods Eighteen intact minipig knees (nine males, nine females) underwent MRI to determine the femoral bicondylar width, intercondylar notch size (width, area and index), medial and lateral tibial slope, ACL size (length, cross-sectional area, and volume), and medial compartment tibiofemoral cartilage thickness. AP knee laxity at 30°, 60°, and 90°flexion and ACL tensile structural properties were measured using custom-designed loading fixtures in a universal tensile testing apparatus. Comparisons between males and females were performed for all anatomic and biomechanical measures. The findings then were compared with published data from human knees. Results Female pigs had smaller bicondylar widths (2.9 mm, ratio = 0.93, effect size = À1.5) and intercondylar notches (width: 2.0 mm, ratio = 0.79, effect size = À2.8; area: 30.8 mm 2 , ratio = 0.76, effect size = 2.1; index: 0.4, ratio = 0.84, effect size = À2.0), steeper lateral tibial slope (4.3°, ratio = 1.13, effect size = 1.1), smaller ACL (length: 2.7 mm, ratio = 0.91, effect size = 1.1; area: 6.8 mm 2 , ratio = 0.74, effect size = À1.5; volume: 266.2 mm 3 , ratio = 0.68, effect size = À1.5), thinner medial femoral cartilage (0.4 mm, ratio = 0.8, effect size = À1.1), lower ACL yield load (275 N, ratio = 0.81, effect size = À1.1), and greater AP knee laxity at 30°( 0.7 mm, ratio = 1.32, effect size = 1.1) and 90°(0.5 mm, ratio = 1.24, effect size = 1

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Section: Anatomic Indices Measurementmentioning

confidence: 99%

“…3). The intercondylar notch area was measured by outlining the outer boundary of the notch space using the oblique-axial view as described by Dienst et al [18] (Fig. 3).…”

Section: Tibial Slopementioning

confidence: 99%

Validation of Porcine Knee as a Sex-specific Model to Study Human Anterior Cruciate Ligament Disorders

Kiapour

Shalvoy

Murray

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…4 Despite the clinical significance, factors contributing to the higher incidence remain unclear. Proposed causes include women having a larger Q-angle, [5][6][7] wider pelvis, 8,9 narrower intercondylar notch, [10][11][12] different hormonal status, [13][14][15] different patterns of muscle activity during jumping, landing, and pivoting, [16][17][18] larger knee joint laxity, [19][20][21][22][23][24] and higher likelihood of ACL impingement against the intercondylar notch. 25,26 Considering that the highest injury incidence is in individuals 15 to 25 years old who participate in pivoting sports, 1 knee biomechanical properties in internal and external tibial rotation may play an important role.…”

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confidence: 99%

Gender differences in passive knee biomechanical properties in tibial rotation

Park

Wilson

Zhang

2008

Journal Orthopaedic Research

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The anterior cruciate ligament (ACL) is the most commonly injured knee ligament with the highest incidence of injury in female athletes who participate in pivoting sports. Noncontact ACL injuries commonly occur with both internal and external tibial rotation. ACL impingement against the lateral wall of the intercondylar notch during tibial external rotation and abduction has been proposed as an injury mechanism, but few studies have evaluated in vivo gender-specific differences in laxity and stiffness in external and internal tibial rotations. The purpose of this study was to evaluate these differences. The knees of 10 male and 10 female healthy subjects were rotated between internal and external tibial rotation with the knee at 608 of flexion. Joint laxity, stiffness, and energy loss were compared between male and female subjects. Women had higher laxity (p ¼ 0.01), lower stiffness (p ¼ 0.038), and higher energy loss (p ¼ 0.008) in external tibial rotation than did men. The results suggest that women may be at greater risk of ACL injury resulting from impingement against the lateral wall of the intercondylar notch, which has been shown to be associated with external tibial rotation and abduction. ß

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“…Anatomic and hormonal factors, such as ACL circumference, joint laxity, and menstrual phase, have been discussed as increased risk factors for noncontact ACL injuries in females. [14][15][16] However, modifying these particular risk factors is difficult if not impossible. In contrast, evidence indicates that neuromuscular risk factors are modifiable.…”

mentioning

confidence: 99%

Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

Sugimoto

Myer

Bush

et al. 2012

Journal of Athletic Training

168

148

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Context:No consensus exists about the influence of compliance with neuromuscular training programs on reduction of the risk of anterior cruciate ligament (ACL) injury.Objective: To systematically review and synthesize the published literature to determine if compliance with neuromuscular training is associated with reduced incidence of ACL injury in young female athletes.Data Sources: We searched PubMed, SPORTDiscus, CINAHL, and MEDLINE for articles published from 1995 to 2010 using the key words anterior cruciate ligament prevention, ACL prevention, knee prevention, prospective knee prevention, neuromuscular training, and neuromuscular intervention.Study Selection: Criteria for inclusion required that (1) the number of ACL injuries was reported, (2) a neuromuscular training program was used, (3) females were included as participants, (4) the study design was prospective and controlled, and (5) compliance data for the neuromuscular training program were provided.Data Extraction: Extracted data included the number of ACL injuries, total number of participants per group, observation time period, number of participants who completed each session, number of sessions completed by an entire team, and number of total sessions. Attendance was calculated as the number of participants who completed each session converted into a percentage of the total number of participants. Intervention completion was calculated as the number of sessions completed by an entire team converted into a percentage of the total number of training sessions. These data were used to calculate an overall rate of compliance.Data Synthesis: Six of 205 identified studies were included. Incidence rates of ACL injury were lower in studies with high rates of compliance with neuromuscular training than in studies with low compliance rates (incidence rate ratio ¼ 0.27 [95% confidence interval ¼ 0.07, 0.80]). Tertile analysis indicated rates of ACL injury incidence were lower in studies with high compliance rates than in studies with moderate and low compliance rates (incidence rate ratio ¼ 0.18 [95% confidence interval ¼ 0.02, 0.77]).Conclusions: A potential inverse dose-response relationship exists between compliance with neuromuscular training and incidence of ACL injury. Attending and completing recommended neuromuscular sessions appears to be an important factor for preventing ACL injuries.Key Words: knee, injury prevention, exercises Key PointsHigher rates of compliance with neuromuscular training programs were associated with lower rates of anterior cruciate ligament (ACL) injury incidence among physically active young females. A potential inverse dose-response relationship exists between compliance with neuromuscular training and the incidence of ACL injury in young female athletes. Attending and completing prescribed neuromuscular training sessions seem to be integral components of preventing ACL injuries in young female athletes.

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Correlation of intercondylar notch cross sections to the ACL size: a high resolution MR tomographic in vivo analysis

Cited by 128 publications

References 24 publications

Validation of Porcine Knee as a Sex-specific Model to Study Human Anterior Cruciate Ligament Disorders

Validation of Porcine Knee as a Sex-specific Model to Study Human Anterior Cruciate Ligament Disorders

Gender differences in passive knee biomechanical properties in tibial rotation

Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

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