Three-Dimensional Intercondylar Notch Volumes in a Skeletally Immature Pediatric Population: A Magnetic Resonance Imaging–Based Anatomic Comparison of Knees With Torn and Intact Anterior Cruciate Ligaments

Swami, Vimarsha G.; Mabee, Myles; Hui, Catherine; Jaremko, Jacob L.

doi:10.1016/j.arthro.2013.08.031

Cited by 40 publications

(43 citation statements)

References 30 publications

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“…[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.…”

Section: Introductionmentioning

confidence: 99%

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

Geng

Wang²,

Ma³

et al. 2016

Chinese Medical Journal

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Background:Few data are available concerning intercondylar notch dimensions in female nonathletes with knee osteoarthritis (OA) in plateau region. The aim of this study was to assess the relation of intercondylar notch morphology to anterior cruciate ligament (ACL) injuries in female nonathletes with knee OA aged 41–65 years from the Chinese Loess Plateau.Methods:The study was conducted on 330 patients with ACL injury (aged 31–65 years; 159 males, 171 females), 141 patients with OA (aged 31–65 years; 59 males, 82 females), and 89 female healthy controls (aged 41–65 years), and this evaluation included identifying the distribution of patients with OA or ACL injury and measuring the intercondylar notch width indexes (NWIs).Results:There was a significant rising trend in patients with OA (the Kellgren and Lawrence grade = 3) with ACL injury (OA-S + ACL) aged 41–65 years, especially in females. We found that the notches of OA-S + ACL had a smaller NWI compared with control and OA without ACL injury (OA-S-only, P = 0.000, 95% confidence interval [CI] = −0.059–−0.030; P = 0.000, 95% CI = −0.049–−0.016). A similar trend was found in notch shape index (NSI), but not in notch depth index and the cross-sectional area. The cutoff of NWI and NSI value was 0.26, and 0.65, and area under the receiver operating characteristic curve was 0.82, and 0.79, respectively. Further study displayed a significant correlation between a reduced NWI and NSI and OA-S + ACL (P = 0.000, χ2 = 14.012; P = 0.000, χ2 = 14.286).Conclusion:A narrower intercondylar notch and a plateau environment are risk factors of predisposing female nonathletes with knee OA to ACL injury aged 41–65 years.

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Section: Introductionmentioning

confidence: 99%

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

Geng

Wang²,

Ma³

et al. 2016

Chinese Medical Journal

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“…To avoid racial bias, all of the participants were Han Chinese. Juveniles were excluded due to their open epiphyseal plates and potential age-related changes in the femoral notches [10]. Due to the potential osteophytosis of the femoral notch that is caused by degenerative changes with age, middle-aged and elderly individuals were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…The notch volume, which is a 3D notch parameter, describes the spatial dimensions of the femoral intercondylar notch and is an extension of the 2D parameters. Most studies, with the exception of one [13], have come to the conclusion that a smaller notch volume indicates a higher risk of ACL injury [8, 10, 11, 15]. However, due to the higher technical threshold and the more complicated measurement, the application of the notch volume measurement has been limited.…”

Section: Introductionmentioning

confidence: 99%

The correlation between common 2D femoral notch parameters and 3D notch volume: a retrospective MRI study

Zhang¹,

Zhang²,

Fang³

et al. 2019

BMC Musculoskelet Disord

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Background Although the stenotic femoral intercondylar notch was associated with anterior cruciate ligament (ACL) injuries, the parameters for notch assessment were numerous. The present study aimed to compare the 2-dimensional (2D) femoral notch parameters, including the notch width (NW) and notch width index (NWI), with the 3-dimensional (3D) notch volume based on magnetic resonance imaging (MRI), to determine appropriate femoral parameters for ACL injuries. Methods Two hundred forty individuals were included in this study, including 120 patients with ACL ruptures and 120 age- and gender-matched individuals without ACL ruptures. The NWs and NWIs were measured at four sites (the popliteal groove, the notch inlet and outlet, and the ACL attachment), and the notch volumes were calculated. The Pearson correlation coefficients between the 2D and 3D parameters were calculated. A multivariate analysis of the ACL injuries was conducted with these parameters and the demographic data. Results The associations of the NW and NWI with the notch volume at each of the four locations of the femoral notch were poor in the subgroup analysis, with the exception of the NW in the male ACL-intact group (R = 0.307, 0.256, 0.404 and 0.387 at the popliteal groove, notch inlet and outlet, and ACL attachment, respectively). The multivariate analysis revealed that the notch volume (OR = 0.679, P < 0.001) and the NW at the popliteal groove (OR = 0.844, P = 0.004), notch inlet (OR = 0.720, P < 0.001) and ACL attachment (OR = 0.871, P = 0.028) were predictable parameters to the risk of ACL injuries. Conclusions The correlations between the 2D parameters and the 3D volumes were weak. The notch volume and the NW at the popliteal groove, notch inlet and ACL attachment were useful parameters for predicting the risk of ACL injuries. Level of evidence Level III, case-control study.

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“…With regard to hormonal risk factors, several studies have discovered sex hormone receptors within the ACL, including those for estrogen 37,38 , testosterone, and relaxin 39 , which may alter the biomechanical properties of the ACL, although the precise mechanism is not completely understood 40,41 . Anatomical risk factors include increased anterior pelvic tilt, increased femoral anteversion, increased quadriceps angle, decreased intercondylar notch width or volume, and increased posterior tibial slope [42][43][44][45][46][47][48] . Females tend to exhibit several of these anatomical characteristics more frequently than males, possibly increasing noncontact ACL injury risk 39,42,49 .…”

Section: Risk Factors For Acl Injury In Youth Athletesmentioning

confidence: 99%

Management of ACL Injuries in Children and Adolescents

Fabricant

Kocher

2017

The Journal of Bone and Joint Surgery

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ä Children and adolescent athletes constitute the largest demographic of patients who sustain anterior cruciate ligament (ACL) tears, and the frequency is increasing. ä In ACL-deficient children and adolescents, continued symptoms of instability can result in progressive meniscal and cartilage damage as well as arthritic changes. ä Growth disturbance can occur after ACL surgery in children, and includes tibial recurvatum due to tibial tubercle apophyseal arrest as well as limb-length discrepancy and/or angular deformity due to physeal arrest or overgrowth. ä Several "physeal sparing" and "physeal respecting" ACL reconstruction techniques have been developed for use in skeletally immature patients to minimize the risk of growth disturbance, with favorable clinical outcomes. ä ACL injury prevention strategies include neuromuscular conditioning and may be performed to prevent both initial ACL injury as well as reinjury and injury of the contralateral ACL after reconstruction. Disclosure: No internal or external funding was provided for this project. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/B603).

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Three-Dimensional Intercondylar Notch Volumes in a Skeletally Immature Pediatric Population: A Magnetic Resonance Imaging–Based Anatomic Comparison of Knees With Torn and Intact Anterior Cruciate Ligaments

Cited by 40 publications

References 30 publications

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

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

The correlation between common 2D femoral notch parameters and 3D notch volume: a retrospective MRI study

Management of ACL Injuries in Children and Adolescents

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