Knee shape might predict clinical outcome after an anterior cruciate ligament rupture

Abstract

We have investigated whether shape of the knee can predict the clinical outcome of patients after an anterior cruciate ligament rupture. We used statistical shape modelling to measure the shape of the knee joint of 182 prospectively followed patients on lateral and Rosenberg view radiographs of the knee after a rupture of the anterior cruciate ligament. Subsequently, we associated knee shape with the International Knee Documentation Committee subjective score at two years follow-up. The mean age of patients was 31 years (21 to 51), the majority were male (n = 121) and treated operatively (n = 135). We found two modes (shape variations) that were significantly associated with the subjective score at two years: one for the operatively treated group (p = 0.002) and one for the non-operatively treated group (p = 0.003). Operatively treated patients who had higher subjective scores had a smaller intercondylar notch and a smaller width of the intercondylar eminence. Non-operatively treated patients who scored higher on the subjective score had a more pyramidal intercondylar notch as opposed to one that was more dome-shaped. We conclude that the shape of the femoral notch and the intercondylar eminence is predictive of clinical outcome two years after a rupture of the anterior cruciate ligament.

The Influence of Tibial and Femoral Bone Morphology on Knee Kinematics in the Anterior Cruciate Ligament Injured Knee

“…Eggerding et al, followed 257 patients prospectively after ACL injury to determine if morphological features identified on radiographs could predict IKDC knee stability scores. 27 Statistical shape modeling, which is an unbiased method for determining unique shape features common within a group of patients, was used to explore bony geometry on lateral and 45-degree, bent-knee PA radiographs. A pyramidal-shaped intercondylar notch was associated with higher IKDC scores 2 years after injury as compared to patients with dome-shaped intercondylar notches (Figure 3).…”

Narrow Intercondylar Notch and Anterior Cruciate Ligament Injury in Female Nonathletes with Knee Osteoarthritis Aged 41–65 Years in Plateau Region

“…[91011] Intercondylar notch size is one of the anatomic variables suspected to predispose an individual to ACL injury. [121314151617] Numerous studies measured notch width index (NWI), notch shape index (NSI), notch depth index (NDI), and the cross-sectional area (CSA), and considered a smaller or stenotic NWI, NSI, NDI, or CSA was a risk factor of ACL injury. [1819202122] One of the main features of patients with OA is the growth of osteophytes, and ACL may be missing in patients of severe OA with significantly smaller intercondylar notch relative to the normal knee.…”

Anterior Cruciate Ligament Injury—Who Succeeds Without Reconstructive Surgery? The Delaware-Oslo ACL Cohort Study

“… 5 , 8 , 22 There is markedly less knowledge on predictive factors in the nonsurgical population. Older age, 3 , 32 lower activity level, 3 absence of a medial meniscal tear, 32 and having a more pyramid-shaped intercondylar notch 4 may predict better outcomes in nonsurgically treated patients. Measures of knee function, such as single-leg hop tests, quadriceps muscle strength, and patient-reported outcome measures (PROMs), predict outcomes in both nonsurgically treated patients 7 , 15 and those who undergo ACLR.…”