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Ön Çapraz Bağ Yaralanmalı Erkek Hastalarda Femoral Çentik Morfolojisinin Değerlendirilmesi: MRI Çalışması

Year 2022, Volume: 6 Issue: 3, 225 - 230, 31.12.2022
https://doi.org/10.30565/medalanya.1069144

Abstract

Amaç: Bu çalışmanın amacı, sporcu olmayan, erkek, ön çapraz bağ (ÖÇB) yaralanmalı hastalarda femoral çentik tipi, çentik genişlik indeksi (NWI), çentik açısı (NA) ve α açısını manyetik rezonans görüntüleme (MRI) kullanarak değerlendirmek ve karşılaştırmaktır.

Yöntemler: Komplet ÖÇB yırtığı olan 79 hastanın ve 80 hastalık kontrol grubunun (19-43 yaş arası) diz MRI görüntüleri değerlendirildi. NWI, NA ölçümleri ve çentik şekli, eksenel yağa doymuş proton ağırlıklı sekanslar üzerinden değerlendirildi. Femoral çentik şekli A, U ve W tipleri olarak sınıflandırıldı.

Bulgular: Çentik tipi, NWI, NA ve ACL yaralanması arasında istatistiksel olarak anlamlı bir ilişki bulundu (p<0,001). ÖÇB yaralanmalı grupta; A tipi çentik (%79.75), kontrol grubundan (%24) önemli ölçüde daha yüksekti. ÖÇB hasarlı grupta NWI kontrol grubuna göre daha düşüktü (0.249 ± 0.020 vs 0.281 ± 0.022). Çentik açısı ÖÇB hasarlı grupta kontrol grubuna göre daha düşüktü (47.15 º ± 5.63 º vs 50.73 º ± 5.44º). Stenotik çentik tipi A ile NWI arasında anlamlı bir ilişki mevcut idi (p <0,001). ÖÇB yaralanmalı hastalarda α açısı kontrol grubuna göre daha düşüktü ancak istatistiksel olarak fark yoktu (41.9 º ±2.79 ºvs 42.06 º ±2.53 º; p= 0.978).

Sonuç: Bu çalışma, düşük NWI, NA değerlerinin ÖÇB yaralanması için bir risk faktörü gibi görünse de, en güçlü prediktif faktörün stenotik femoral çentik tip A olduğunu göstermiştir. α açısı ÖÇB yaralanmasında anlamlı bir korelasyon göstermemiştir.

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References

  • 1. Mountcastle SB, Posner M, Kragh JF Jr, Taylor DC. Gender differences in anterior cruciate ligament injury vary with activity: epidemiology of anterior cruciate ligament injuries in a young, athletic population. Am J Sports Med. 2007;35(10):1635-42. doi: 10.1177/0363546507302917
  • 2. Atik OŞ. Does Surgical Treatment of Anterior Cruciate Ligament Tear Prevent Osteoarthritis? Acta Medica Alanya. 2017;2(1):55. doi: 10.30565/medalanya.328575
  • 3. Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med. 2008;42(6):394-412. doi: 10.1136/bjsm.2008.048934
  • 4. Alentorn-Geli E, Mendiguchía J, Samuelsson K, Musahl V, Karlsson J, Cugat R et al. Prevention of anterior cruciate ligament injuries in sports. Part I: systematic review of risk factors in male athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(1):3-15. doi: 10.1007/s00167-013-2725-3
  • 5. Wada M, Tatsuo H, Baba H, Asamoto K, Nojyo Y. Femoral intercondylar notch measurements in osteoarthritic knees. Rheumatology (Oxford). 1999;38(6):554-8. doi: 10.1093/rheumatology/38.6.554
  • 6. Stein V, Li L, Guermazi A, Zhang Y, Kwoh CK, Eaton CB et al. The relation of femoral notch stenosis to ACL tears in persons with knee osteoarthritis. Osteoarthritis Cartilage. 2010;18(2):192-9. doi: 10.1016/j.joca.2009.09.006
  • 7. van Eck CF, Martins CA, Vyas SM, Celentano U, van Dijk CN, Fu FH. Femoral intercondylar notch shape and dimensions in ACL-injured patients. Knee Surg Sports Traumatol Arthrosc. 2010;18(9):1257-62. doi: 10.1007/s00167-010-1135-z
  • 8. Al-Saeed O, Brown M, Athyal R, Sheikh M. Association of femoral intercondylar notch morphology, width index and the risk of anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):678-82. doi: 10.1007/s00167-012-2038-y
  • 9. Domzalski M, Grzelak P, Gabos P. Risk factors for Anterior Cruciate Ligament injury in skeletally immature patients: analysis of intercondylar notch width using Magnetic Resonance Imaging. Int Orthop. 2010;34(5):703-7. doi: 10.1007/s00264-010-0987-7
  • 10. Fernández-Jaén T, López-Alcorocho JM, Rodriguez-Iñigo E, Castellán F, Hernández JC, Guillén-García P. The Importance of the Intercondylar Notch in Anterior Cruciate Ligament Tears. Orthop J Sports Med. 2015;3(8):2325967115597882. doi: 10.1177/2325967115597882
  • 11. Sutton KM, Bullock JM. Anterior cruciate ligament rupture: differences between males and females. J Am Acad Orthop Surg. 2013;21(1):41-50. doi: 10.5435/JAAOS-21-01-41
  • 12. Basukala B, Joshi A, Pradhan I. The Effect of the Intercondylar Notch Shape and Notch Width Index on Anterior Cruciate Ligament Injuries. J Nepal Health Res Counc. 2020;17(4):532-6. doi: 10.33314/jnhrc.v17i4.1858
  • 13. Shen L, Jin ZG, Dong QR, Li LB. Anatomical Risk Factors of Anterior Cruciate Ligament Injury. Chin Med J (Engl). 2018;131(24):2960-7. doi: 10.4103/0366-6999.247207
  • 14. Huang M, Li Y, Li H, Liao C, Xu H, Luo X. Predictive effects of the intercondylar notch morphology on anterior cruciate ligament injury in males: A magnetic resonance imaging analysis. Medicine (Baltimore). 2020;99(10):e19411. doi: 10.1097/MD.0000000000019411
  • 15. Souryal TO, Moore HA, Evans JP. Bilaterality in anterior cruciate ligament injuries: associated intercondylar notch stenosis. Am J Sports Med. 1988;16(5):449-54. doi: 10.1177/036354658801600504
  • 16. Uhorchak JM, Scoville CR, Williams GN, Arciero RA, St Pierre P, Taylor DC. Risk factors associated with noncontact injury of the anterior cruciate ligament: a prospective four-year evaluation of 859 West Point cadets. Am J Sports Med. 2003;31(6):831-42. doi: 10.1177/03635465030310061801
  • 17. LaPrade RF, Burnett QM 2nd. Femoral intercondylar notch stenosis and correlation to anterior cruciate ligament injuries. A prospective study. Am J Sports Med. 1994;22(2):198-203. doi: 10.1177/036354659402200208
  • 18. van Diek FM, Wolf MR, Murawski CD, van Eck CF, Fu FH. Knee morphology and risk factors for developing an anterior cruciate ligament rupture: an MRI comparison between ACL-ruptured and non-injured knees. Knee Surg Sports Traumatol Arthrosc. 2014;22(5):987-94. doi: 10.1007/s00167-013-2588-7
  • 19. Vrooijink SH, Wolters F, Van Eck CF, Fu FH. Measurements of knee morphometrics using MRI and arthroscopy: a comparative study between ACL-injured and non-injured subjects. Knee Surg Sports Traumatol Arthrosc. 2011;19 Suppl 1:S12-6. doi :10.1007/s00167-011-1502-4
  • 20. Bouras T, Fennema P, Burke S, Bosman H. Stenotic intercondylar notch type is correlated with anterior cruciate ligament injury in female patients using magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc. 2018;26(4):1252-7. doi: 10.1007/s00167-017-4625-4
  • 21. Herzog RJ, Silliman JF, Hutton K, Rodkey WG, Steadman JR. Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging. Am J Sports Med. 1994;22(2):204-10. doi: 10.1177/036354659402200209
  • 22. Anderson AF, Lipscomb AB, Liudahl KJ, Addlestone RB. Analysis of the intercondylar notch by computed tomography. Am J Sports Med. 1987;15(6):547-52. doi: 10.1177/036354658701500605
  • 23. Cha JH, Lee SH, Shin MJ, Choi BK, Bin SI. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation. Skeletal Radiol. 2008;37(9):821-6. doi: 10.1007/s00256-008-0527-3

Assessment of femoral notch morphology in male patients with anterior cruciate ligament injury: an MRI study

Year 2022, Volume: 6 Issue: 3, 225 - 230, 31.12.2022
https://doi.org/10.30565/medalanya.1069144

Abstract

Aim: The objective of the present study was to evaluate the femoral notch type, notch width index (NWI), notch angle (NA) and α angle in patients with ACL injury and compare with nonathletic male population, using magnetic resonance imaging (MRI).

Methods: 79 patients with complete ACL tear and 80 patients as control group (aged 19-43 years) who had knee MRI were evaluated. NWI, NA measurements and notch shape were evaluated on axial fat-saturated proton-weighted sequences. Femoral notch shape was classified as A, U and W types.

Results: A statistically significant association was found between notch type, NWI, NA and ACL injury (p<0,001). Type A notch in the ACL-injured group (79.75 %) was significantly higher than the control group (24%). NWI was lower in patients with ACL-injured group than in control group (0.249 ± 0.020 vs 0.281 ± 0.022) Notch angle was lower in patients with ACL-injured group than in control group (47.15 º ± 5.63 º vs 50.73 º ± 5.44º). A significant association between stenotic notch type A and NWI (p <0,001). The α angle was lower in patients with ACL-injured group than in control group but it was not statistically different (41.9 º ±2.79 ºvs 42.06 º ±2.53 º; p= 0.978).

Conclusion: This study showed that however low NWI, NA values are a risk factor for ACL injury, the strongest predictive factor was stenotic femoral notch type A. α angle had no significant correlation in ACL injury.

References

  • 1. Mountcastle SB, Posner M, Kragh JF Jr, Taylor DC. Gender differences in anterior cruciate ligament injury vary with activity: epidemiology of anterior cruciate ligament injuries in a young, athletic population. Am J Sports Med. 2007;35(10):1635-42. doi: 10.1177/0363546507302917
  • 2. Atik OŞ. Does Surgical Treatment of Anterior Cruciate Ligament Tear Prevent Osteoarthritis? Acta Medica Alanya. 2017;2(1):55. doi: 10.30565/medalanya.328575
  • 3. Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med. 2008;42(6):394-412. doi: 10.1136/bjsm.2008.048934
  • 4. Alentorn-Geli E, Mendiguchía J, Samuelsson K, Musahl V, Karlsson J, Cugat R et al. Prevention of anterior cruciate ligament injuries in sports. Part I: systematic review of risk factors in male athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(1):3-15. doi: 10.1007/s00167-013-2725-3
  • 5. Wada M, Tatsuo H, Baba H, Asamoto K, Nojyo Y. Femoral intercondylar notch measurements in osteoarthritic knees. Rheumatology (Oxford). 1999;38(6):554-8. doi: 10.1093/rheumatology/38.6.554
  • 6. Stein V, Li L, Guermazi A, Zhang Y, Kwoh CK, Eaton CB et al. The relation of femoral notch stenosis to ACL tears in persons with knee osteoarthritis. Osteoarthritis Cartilage. 2010;18(2):192-9. doi: 10.1016/j.joca.2009.09.006
  • 7. van Eck CF, Martins CA, Vyas SM, Celentano U, van Dijk CN, Fu FH. Femoral intercondylar notch shape and dimensions in ACL-injured patients. Knee Surg Sports Traumatol Arthrosc. 2010;18(9):1257-62. doi: 10.1007/s00167-010-1135-z
  • 8. Al-Saeed O, Brown M, Athyal R, Sheikh M. Association of femoral intercondylar notch morphology, width index and the risk of anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):678-82. doi: 10.1007/s00167-012-2038-y
  • 9. Domzalski M, Grzelak P, Gabos P. Risk factors for Anterior Cruciate Ligament injury in skeletally immature patients: analysis of intercondylar notch width using Magnetic Resonance Imaging. Int Orthop. 2010;34(5):703-7. doi: 10.1007/s00264-010-0987-7
  • 10. Fernández-Jaén T, López-Alcorocho JM, Rodriguez-Iñigo E, Castellán F, Hernández JC, Guillén-García P. The Importance of the Intercondylar Notch in Anterior Cruciate Ligament Tears. Orthop J Sports Med. 2015;3(8):2325967115597882. doi: 10.1177/2325967115597882
  • 11. Sutton KM, Bullock JM. Anterior cruciate ligament rupture: differences between males and females. J Am Acad Orthop Surg. 2013;21(1):41-50. doi: 10.5435/JAAOS-21-01-41
  • 12. Basukala B, Joshi A, Pradhan I. The Effect of the Intercondylar Notch Shape and Notch Width Index on Anterior Cruciate Ligament Injuries. J Nepal Health Res Counc. 2020;17(4):532-6. doi: 10.33314/jnhrc.v17i4.1858
  • 13. Shen L, Jin ZG, Dong QR, Li LB. Anatomical Risk Factors of Anterior Cruciate Ligament Injury. Chin Med J (Engl). 2018;131(24):2960-7. doi: 10.4103/0366-6999.247207
  • 14. Huang M, Li Y, Li H, Liao C, Xu H, Luo X. Predictive effects of the intercondylar notch morphology on anterior cruciate ligament injury in males: A magnetic resonance imaging analysis. Medicine (Baltimore). 2020;99(10):e19411. doi: 10.1097/MD.0000000000019411
  • 15. Souryal TO, Moore HA, Evans JP. Bilaterality in anterior cruciate ligament injuries: associated intercondylar notch stenosis. Am J Sports Med. 1988;16(5):449-54. doi: 10.1177/036354658801600504
  • 16. Uhorchak JM, Scoville CR, Williams GN, Arciero RA, St Pierre P, Taylor DC. Risk factors associated with noncontact injury of the anterior cruciate ligament: a prospective four-year evaluation of 859 West Point cadets. Am J Sports Med. 2003;31(6):831-42. doi: 10.1177/03635465030310061801
  • 17. LaPrade RF, Burnett QM 2nd. Femoral intercondylar notch stenosis and correlation to anterior cruciate ligament injuries. A prospective study. Am J Sports Med. 1994;22(2):198-203. doi: 10.1177/036354659402200208
  • 18. van Diek FM, Wolf MR, Murawski CD, van Eck CF, Fu FH. Knee morphology and risk factors for developing an anterior cruciate ligament rupture: an MRI comparison between ACL-ruptured and non-injured knees. Knee Surg Sports Traumatol Arthrosc. 2014;22(5):987-94. doi: 10.1007/s00167-013-2588-7
  • 19. Vrooijink SH, Wolters F, Van Eck CF, Fu FH. Measurements of knee morphometrics using MRI and arthroscopy: a comparative study between ACL-injured and non-injured subjects. Knee Surg Sports Traumatol Arthrosc. 2011;19 Suppl 1:S12-6. doi :10.1007/s00167-011-1502-4
  • 20. Bouras T, Fennema P, Burke S, Bosman H. Stenotic intercondylar notch type is correlated with anterior cruciate ligament injury in female patients using magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc. 2018;26(4):1252-7. doi: 10.1007/s00167-017-4625-4
  • 21. Herzog RJ, Silliman JF, Hutton K, Rodkey WG, Steadman JR. Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging. Am J Sports Med. 1994;22(2):204-10. doi: 10.1177/036354659402200209
  • 22. Anderson AF, Lipscomb AB, Liudahl KJ, Addlestone RB. Analysis of the intercondylar notch by computed tomography. Am J Sports Med. 1987;15(6):547-52. doi: 10.1177/036354658701500605
  • 23. Cha JH, Lee SH, Shin MJ, Choi BK, Bin SI. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation. Skeletal Radiol. 2008;37(9):821-6. doi: 10.1007/s00256-008-0527-3
There are 23 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research Article
Authors

Ayşe Serap Akgün 0000-0002-9610-2209

Aybars Tekcan 0000-0003-3078-1285

Publication Date December 31, 2022
Submission Date February 8, 2022
Acceptance Date October 21, 2022
Published in Issue Year 2022 Volume: 6 Issue: 3

Cite

Vancouver Akgün AS, Tekcan A. Assessment of femoral notch morphology in male patients with anterior cruciate ligament injury: an MRI study. Acta Med. Alanya. 2022;6(3):225-30.

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