Increased Posterior Tibial Slope Is Associated With Greater Risk of Graft Roof Impingement After Anatomic Anterior Cruciate Ligament Reconstruction

Song, Gonghua; Ni, Qiankun; Zheng, Tong; Feng, Hao; Zhang, Zhijun; Zhang, Hui

doi:10.1177/03635465211018859

Cited by 12 publications

(8 citation statements)

References 38 publications

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“…It is well accepted that the volumes of the intercondylar notch, the PCL, and the ACL are all positively correlated. A question still unresolved is whether patients with smaller cruciate ligaments and smaller intercondylar notches rupture their ligament because of the relatively smaller force they can withhold, or because of chronic or acute damage because of notch impingement to the cruciate ligaments [ 1 , 5 , 19 , 27 ]. However, notch impingement may play a lesser role in the risk for sustaining a PCL rupture, because of the anatomical position of the PCL posterior in the knee.…”

Section: Discussionmentioning

confidence: 99%

Smaller intercondylar notch size and smaller ACL volume increase posterior cruciate ligament rupture risk

Kuijk

Reijman

Bierma-Zeinstra

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Little is known about risk factors for sustaining a posterior cruciate ligament (PCL) rupture. Identifying risk factors is the first step in preventing a PCL rupture from occurring. The morphology of the knee in patients who ruptured their PCL may differ from that of control patients. The hypothesis was that the intercondylar notch dimensions, 3-D volumes of the intercondylar notch and, the 3-D volumes of both the ACL and the PCL were correlated to the presence of a PCL rupture. Methods The magnetic resonance imaging (MRI) scans of 30 patients with a proven PCL rupture were compared to 30 matched control patients with proven intact ACL and PCL. Control patients were selected from patients with knee trauma during sports but without cruciate ligament injury. Patients have been matched for age, height, weight, BMI, and sex. The volumes of the intercondylar notch and both the ACL and PCL were measured on 3D reconstructions. Second, the bicondylar width, the notch width, and the notch width index were measured of all subjects. The relationship between our measurements and the presence of a PCL rupture was analysed. Results The results show a significant difference in the volumes of the intercondylar notch and the ACL between patients with a ruptured PCL and control patients. Patients with a PCL rupture have smaller intercondylar notch volumes and smaller ACL volumes. There were no significant differences in the bicondylar width, notch width, and notch width index. In the control patients, a significant correlation between the volume of the PCL and the volume of the ACL was found (0.673, p < 0.001). Conclusion Patients with a PCL rupture have smaller intercondylar volumes and smaller ACL volumes when compared to control patients. Second, patients with smaller ACL volumes have smaller PCL volumes. This study shows, for the first time, that there are significant size and volume differences in the shape of the knee between patients with a PCL rupture and control patients. Level of evidence IV.

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Section: Discussionmentioning

confidence: 99%

Smaller intercondylar notch size and smaller ACL volume increase posterior cruciate ligament rupture risk

Kuijk

Reijman

Bierma-Zeinstra

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…In our study, the images were evaluated by two musculoskeletal radiologists blinded to the results of each other. A similar approach was done by many other studies [ 7 , 8 , 17 ].…”

Section: Discussionmentioning

confidence: 92%

“…In our study, we used a 1.5-Tesla MRI scanner which we think it could provide more information about an ACL injury than a less available and probably more expensive study performed on a 3-Tesla scanner. Other previous studies evaluated also the role of 1.5-Tesla MRI in evaluation of ACL and ACL graft [ 6 , 17 ]. On the other hand, many other recent studies have discussed the role of 3-Tesla MRI in evaluation of ACL grafts [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Not only we evaluated the role of oblique sagittal and oblique coronal MRI for assessment of ACL graft injury, but we also evaluated their role in grading the severity of ACL graft injury. Teraoka et al [ 18 ] and Song et al [ 17 ] used a grading system inspired by the one used by Hong et al [ 20 ], as they classified the subjects into three grades based on the MRI findings: grade 1, with low-intensity signal of the graft; grade 2, with high-intensity signal within 50% of the graft; and grade 3, with high-intensity signal greater than 50% of the graft.…”

Section: Discussionmentioning

confidence: 99%

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Use of oblique sagittal and coronal weighted images for diagnosis and grading of ACL graft injury

Elsayed

Rashwan

Kamal

2022

Egypt J Radiol Nucl Med

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Background This study was done to evaluate the value of adding the oblique sagittal and oblique coronal MRI to the standard MRI knee protocol for evaluation of suspected ACL graft injuries. Results This was a cross-sectional analytic study where we reviewed 36 MRI knee examinations of 36 patients (30 males, 6 females, age range: 17–60 years, mean age: 26 years) who were subjected to ACL reconstruction and follow-up arthroscopy. Two experienced radiologists, blinded to the results of each other, evaluated the status and the severity of the ACL graft injury using the routine knee MRI (protocol A) and using the routine MRI after adding the oblique sagittal and coronal imaging (protocol B). Weighted kappa statistics were used to evaluate the diagnostic accuracies of the knee MRI before and after the addition of the oblique sagittal and coronal weighted images (protocol A and protocol B, respectively) and to assess the interobserver agreement. The weighted kappa values according to the routine knee MRI were 0.357 (reader 1) and 0.399 (reader 2). The inclusion of additional oblique coronal imaging increased the weighted kappa values to 0.505 (reader 1) and 0.528 (reader 2). The interobserver agreement weighted kappa value also increased from 0.606 to 0.759 by adding the oblique sagittal and coronal imaging to the routine knee MRI examination. Conclusion The additional use of oblique sagittal and coronal MRI of the knee improves the diagnostic accuracy for diagnosing and grading ACL graft injury with the arthroscopy used as a gold standard.

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“…Impingement is a major problem in ACL reconstruction (Iriuchishima et al, 2013;Schützenberger et al, 2021;Song et al, 2021;Srinivasan et al, 2018). The contact between a reconstructed graft and adjacent tissues is known to be strongly correlated with graft failure.…”

Section: Introductionmentioning

confidence: 99%

A wear model to predict damage of reconstructed ACL

Redin¹,

Caroux²,

Rohan³

et al. 2022

Journal of the Mechanical Behavior of Biomedical Materials

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Increased Posterior Tibial Slope Is Associated With Greater Risk of Graft Roof Impingement After Anatomic Anterior Cruciate Ligament Reconstruction

Cited by 12 publications

References 38 publications

Smaller intercondylar notch size and smaller ACL volume increase posterior cruciate ligament rupture risk

Smaller intercondylar notch size and smaller ACL volume increase posterior cruciate ligament rupture risk

Use of oblique sagittal and coronal weighted images for diagnosis and grading of ACL graft injury

A wear model to predict damage of reconstructed ACL

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