Increased lateral femoral condyle ratio measured by MRI is associated with higher risk of noncontact anterior cruciate ligament injury

Abstract

Background Studies have shown a significant association between the radiographically measured lateral femoral condyle ratio (LFCR) and anterior cruciate ligament (ACL) injury. However, it is unclear whether LFCR measured by magnetic resonance imaging (MRI) is associated with a higher risk of noncontact ACL injury. Objective To investigate the effect of LFCR on the risk of noncontact ACL injury by MRI. 2 to investigate the association of LFCR measured by MRI with multiple bone morphological risk factors and evaluate the most sensitive risk predictors of noncontact ACL injury. Methods A total of 116 patients, including 58 subjects with noncontact ACL injury and 58 age-matched and sex-matched controls with only meniscus injury, were included in this retrospective case-control study. LFCR, lateral tibial slope (LTS), lateral tibial height (LTH), medial tibial slope (MTS), and medial tibial depth (MTD) were measured on MRI. The differences in each index between the two groups were compared, and risk factors were screened by single-factor logistic regression analysis. Indicators with P values < 0.1 were included in the logistic regression equation. The critical values and areas under the curve (AUCs) of independent risk factors were determined by receiver operating characteristic (ROC) curve analysis. Finally, the diagnostic performance of each risk factor was evaluated by the Z-test. Results A total of 116 patients who met the inclusion criteria were included in the final analysis (58 cases in the noncontact ACL injury group and 58 cases in the control group). Patients with noncontact ACL injury had a higher femoral LFCR (0.64 ± 0.03) than patients with isolated meniscus tears. Among all the risk factors for ACL injury, the AUC for LFCR was the largest, at 0.81 (95% CI, 0.73-0.88), and when the critical value was 0.61, the sensitivity and specificity for the diagnosis of ACL injury were 0.79 and 0.67, respectively. When combined with LTH (> 2.35 mm), the diagnostic performance was improved. The AUC was 0.85 (95% CI, 0.78-0.92), the sensitivity was 0.83, and the specificity was 0.76. Conclusion This study shows that an increased LFCR is related to an increased risk of noncontact ACL injury as determined by MRI. LFCR and LTH are sensitive risk factors for noncontact ACL injury and may help clinicians identify individuals prone to ACL injury, allowing prevention and intervention measures to be applied.

Anterior cruciate ligament femoral footprint is oblong‐ovate, triangular, or two‐tears shaped in healthy young adults: three‐dimensional MRI analysis

“…In contrast, earlier studies reported that the mean locations for ACL femoral footprint centres were 23.8–37.3% in the DS direction and 26.6–44.3% in the HL direction [18]. In addition, previous studies indicated a position relative to the ADC ranged from 10.8 to 12.0 mm distally and 9.1 to 9.3 mm anteriorly [9, 18]. For the single‐bundle ACLR, Pearle et al .…”

“…For the BH grid method, Blumensaat’s line was first drawn along the roof of the intercondylar notch of the femur, as seen on the reformatted oblique‐sagittal plane. Subsequently, the coordinates of the ACL femoral footprint centre in the deep–shallow (DS) direction and the high–low (HL) direction were measured. Other anatomical features that have been reported to be associated with ACL injury, like notch shape, Blumensaat’s line type, notch width, condylar width, notch width index (NWI), notch height, condylar height, notch height index (NHI), α angle (°), β angle (°), the lateral femoral condyle ratio (LFCR) and the lateral femoral condyle index (LFCI), which previously reported as related to ACL injury, were evaluated according to the previous studies [9, 11, 24]. With Materialise’s Interactive Medical Image Control System software (Version 21.0, Materialise, Leuven, Belgium), the shape of the ACL femoral footprint was demonstrated on the 3D model through 3D reconstruction (Fig.…”

“…8. Other anatomical features that have been reported to be associated with ACL injury, like notch shape, Blumensaat's line type, notch width, condylar width, notch width index (NWI), notch height, condylar height, notch height index (NHI), α angle (°), β angle (°), the lateral femoral condyle ratio (LFCR) and the lateral femoral condyle index (LFCI), which previously reported as related to ACL injury, were evaluated according to the previous studies [9,11,24].…”

Anatomical factors associated with the development of anterior tibial spine fractures based on MRI measurements

“…Third, we included patients with only meniscal injury in the control group. Although this method has been widely adopted by previous studies [ 24 , 50 , 51 ], the inclusion of this population may introduce some bias.…”

“…This method has been reported as the most reproducible for measuring lateral tibial slope and is independent of the length of proximal tibia [ 19 ]. To determine the most predictive bony morphological risk factors, the following parameters were also measured according to the original description: medial tibial depth (MTD) [ 20 ], lateral tibial height (LTH) [ 21 ], notch width index (NWI) [ 22 ] and lateral femoral condyle ratio (LFCR) [ 23 , 24 ] (Fig. 2 ).…”