The predictive value of radiographs in the evaluation of unilateral and bilateral anterior cruciate ligament injuries

Abstract

A review of 250 cases of surgical reconstruction of the anterior cruciate ligament identified 24 patients with bilateral complete tears of the anterior cruciate ligament. Twenty of these patients had previous reconstruction of one anterior cruciate ligament before rupture of the opposite ligament. Twelve injuries occurred during the same activity that was responsible for the initial opposite injury. The average time between surgical reconstruction and rupture of the opposite ligament was 29.3 months (range, 3 to 103). No significant demographic differences existed between patients with unilateral or bilateral ruptures of the anterior cruciate ligament. Standardized measurements of intercondylar notch height and width and medial and lateral femoral condyle height and width were performed on routine notchview height and width were performed on routine notchview radiographs of 31 knees of patients with bilateral injuries, 30 with unilateral injury, and 30 with no anterior cruciate ligament injury. Statistical analysis revealed no significant differences between the three groups when comparing absolute measures or any of eight mathematical ratios calculated from these measurements. We concluded that measurements of the intercondylar notch made from radiographs may not be reliable predictors of injury to the anterior cruciate ligament. We found no significant clinical or demographic differences between patients with unilateral or bilateral complete ruptures of the anterior cruciate ligament.

Morphometric Analysis of Condyles and Intercondylar Notch of Femur in North Indian Population and Its Clinical Significance

“…18 Notch width index has been traditionally used as an indicator of stenosis (NWI < 0.20) of intercondylar notch. 8,16,17 Notch width index in this study was found to be 0.29, which is very similar to what was obtained by Ameet KJ et al, 12 Ravichandran et al, 6 Wada et al 5 Since there is a strong correlation between stenosis of femoral intercondylar notch and tears of ACL, 15,16 it can be inferred from our study that chances of ACL injury is less in North Indians, NWI being 0.29.…”

“…6 The shapes of the intercondylar notches were observed by many investigators. 8,16,17 Shepstone et al concluded that the shape of the notch may be of some significance (in relation to ACL damage). The notch shape may be of importance, because femora could be of equal notch width (or notch width index), but have different shapes.…”

“…8,9,10 As conflicting data was obtained while reviewing literature, therefore it became essential to explore various parameters of intercondylar notch and femoral condyles and subsequently to see its implications on ACL injury.…”

A radiographic analysis of the relationship between the size and shape of the intercondylar notch and anterior cruciate ligament injury

“…The median age of the patients at the time that radiographs were taken was 17 years (range [14][15][16][17][18][19][20][21]. The self-reported mean height and weight of the patients was 174.2±10.4 cm and 72.7±18.2 kg, respectively.…”

Risk factors for Anterior Cruciate Ligament injury in skeletally immature patients: analysis of intercondylar notch width using Magnetic Resonance Imaging

“…Since that time, several authors have evaluated the role of a narrow intercondylar notch as a risk factor for acute ACL injury. While the majority of studies do suggest that notch stenosis is associated with a higher risk of ACL injury [2][3][4][5][6][7], others did not find significant differences between notch measurements of uninjured athletes and subjects with ACL tears [8][9][10]. We know of only one report focussing on the notch width in a paediatric population [11].…”