TY  - JOUR
T1  - Patellar Tendon Morphometry in Complete ACL Tear: An MRI-Based Case-Control Study
TT  - Tam Kat ACL Yırtığında Patellar Tendon Morfometrisi: MRG Tabanlı Bir Olgu-Kontrol Çalışması
AU  - Cingöz, Eda
AU  - Tor, Onur
AU  - Mavcioglu, Ipek
AU  - Uslu, Muhammed
AU  - Cingöz, Mehmet
AU  - Dursun, Menduh
PY  - 2026
DA  - September
Y2  - 2026
DO  - 10.54005/geneltip.1836310
JF  - Genel Tıp Dergisi
JO  - Genel Tıp Derg
PB  - Selçuk Üniversitesi
WT  - DergiPark
SN  - 2602-3741
SP  - 1
EP  - 7
VL  - 36
IS  - 2026
LA  - en
AB  - Aim: The current study aims to determine whether patellar tendon angles and related morphometric parameters are independently associated with complete ACL tear on MRI.Materials and Methods: In this retrospective case-control study, knee MRIs of 170 patients with arthroscopically confirmed complete ACL tear and 170 age- and sex-matched controls were evaluated. Key measurements included the quadriceps patellar tendon angle (QPTA), patella patellar tendon angle (PPTA), and the distance from the inferior margin of the patellar articular surface to the tibial tuberosity (IPTT), along with several other anatomical parameters.Results: QPTA and PPTA were significantly higher, and IPTT values were significantly lower in the complete ACL tear group (p < 0.05). Multivariate logistic regression analysis demonstrated that increased QPTA (OR: 1.036;95% CI: 1.011-1.061; p=0.004), PPTA (OR: 1.058; 95% CI: 1.004–1.114; p = 0.034), and decreased IPTT (OR: 1.067; 95% CI: 1.022–1.116; p = 0.004) were independently associated with complete ACL tear.Conclusions: Higher QPTA and PPTA values and lower IPTT measurements on MRI were identified as significant anatomical predictors of complete ACL tear, indicating that these patellar tendon-related parameters may help in identifying individuals with imaging findings associated with ACL injury. However, their individual discriminatory performance was modest, and these measurements should be interpreted as contributory parameters rather than standalone markers.
KW  - Anterior Cruciate Ligament Injuries
KW  - Knee Joint
KW  - Magnetic Resonance Imaging
KW  - Patella
KW  - Risk Factors
KW  - Tibia
N2  - Amaç: Bu çalışma, patellar tendon açıları ve ilgili morfometrik parametrelerin MRG’de tam kat ACL yırtığı ile bağımsız olarak ilişkili olup olmadığını belirlemeyi amaçlamaktadır.Gereç ve Yöntemler: Bu retrospektif olgu-kontrol çalışmasında, artroskopi ile doğrulanmış tam kat ACL yırtığı olan 170 hastanın ve yaş - cinsiyete göre eşleştirilmiş 170 kontrolün diz MRG’leri değerlendirildi. Temel ölçümler; quadriceps patellar tendon açısı (QPTA), patella patellar tendon açısı (PPTA) ve patellar eklem yüzeyinin inferior kenarı ile tibial tüberkül arasındaki mesafe (IPTT) ile birlikte çeşitli diğer anatomik parametreleri içeriyordu.Bulgular: Tam kat ACL yırtığı grubunda QPTA ve PPTA anlamlı derecede yüksek, IPTT değerleri ise anlamlı derecede düşüktü (p < 0.05). Çok değişkenli lojistik regresyon analizi, artmış QPTA’nın (OR: 1.036; %95 GA: 1.011–1.061; p = 0.004), artmış PPTA’nın (OR: 1.058; %95 GA: 1.004–1.114; p = 0.034) ve azalmış IPTT’nin (OR: 1.067; %95 GA: 1.022–1.116; p = 0.004) tam kat ACL yırtığı ile bağımsız olarak ilişkili olduğunu gösterdi.Sonuçlar: MRG’de yüksek QPTA ve PPTA değerleri ile düşük IPTT ölçümlerinin, tam kat ACL yırtığı için anlamlı anatomik belirteçler olduğu saptandı ve bu patellar tendonla ilişkili parametrelerin, ACL yaralanması açısından artmış risk taşıyan bireylerin belirlenmesine katkı sağlayabileceği gösterildi. Ancak bu ölçümlerin tek tek ele alındığında ayırt ediciliği sınırlı olup bu nedenle tek başına belirleyici göstergeler olarak değil, değerlendirmeye katkı sağlayan parametreler olarak yorumlanmaları uygun olur.
CR  - 1. Chia L, De Oliveira Silva D, Whalan M, McKay MJ, Sullivan J, Fuller CW, Pappas E: Non-contact Anterior Cruciate Ligament Injury Epidemiology in Team-Ball Sports: A Systematic Review with Meta-analysis by Sex, Age, Sport, Participation Level, and Exposure Type. Sports Med 2022, 52(10):2447-2467.
CR  - 2. Rodriguez-Merchan EC, Encinas-Ullan CA: Knee Osteoarthritis Following Anterior Cruciate Ligament Reconstruction: Frequency, Contributory Elements, and Recent Interventions to Modify the Route of Degeneration. Arch Bone Jt Surg 2022, 10(11):951-958.
CR  - 3. Kızılgöz V, Sivrioğlu AK, Ulusoy GR, Yıldız K, Aydın H, Çetin T: Posterior tibial slope measurement on lateral knee radiographs as a risk factor of anterior cruciate ligament injury: A cross-sectional study. Radiography (Lond) 2019, 25(1):33-38.
CR  - 4. Hohmann E, Tetsworth K, Glatt V, Ngcelwane M, Keough N: Medial and Lateral Posterior Tibial Slope Are Independent Risk Factors for Noncontact ACL Injury in Both Men and Women. Orthop J Sports Med 2021, 9(8):23259671211015940.
CR  - 5. Simon RA, Everhart JS, Nagaraja HN, Chaudhari AM: A case-control study of anterior cruciate ligament volume, tibial plateau slopes and intercondylar notch dimensions in ACL-injured knees. J Biomech 2010, 43(9):1702-1707.
CR  - 6. Shen L, Jin ZG, Dong QR, Li LB: Anatomical Risk Factors of Anterior Cruciate Ligament Injury. Chin Med J (Engl) 2018, 131(24):2960-2967.
CR  - 7. Shen X, Xiao J, Yang Y, Liu T, Chen S, Gao Z, Zuo J: Multivariable analysis of anatomic risk factors for anterior cruciate ligament injury in active individuals. Arch Orthop Trauma Surg 2019, 139(9):1277-1285.
CR  - 8. Kızılgöz V, Sivrioğlu AK, Ulusoy GR, Aydın H, Karayol SS, Menderes U: Analysis of the risk factors for anterior cruciate ligament injury: an investigation of structural tendencies. Clin Imaging 2018, 50:20-30.
CR  - 9. Zeng C, Gao SG, Wei J, Yang TB, Cheng L, Luo W, Tu M, Xie Q, Hu Z, Liu PF et al: The influence of the intercondylar notch dimensions on injury of the anterior cruciate ligament: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2013, 21(4):804-815.
CR  - 10. Li Z, Li C, Li L, Wang P: Correlation between notch width index assessed via magnetic resonance imaging and risk of anterior cruciate ligament injury: an updated meta-analysis. Surg Radiol Anat 2020, 42(10):1209-1217.
CR  - 11. Barnum MS, Boyd ED, Vacek P, Slauterbeck JR, Beynnon BD: Association of Geometric Characteristics of Knee Anatomy (Alpha Angle and Intercondylar Notch Type) With Noncontact ACL Injury. Am J Sports Med 2021, 49(10):2624-2630.
CR  - 12. Wang HM, Shultz SJ, Ross SE, Henson RA, Perrin DH, Schmitz RJ: ACL Size and Notch Width Between ACLR and Healthy Individuals: A Pilot Study. Sports Health 2020, 12(1):61-65.
CR  - 13. Polat AE, Polat B, Gürpınar T, Sarı E, Çarkçı E, Erler K: Tibial tubercle-trochlear groove (TT-TG) distance is a reliable measurement of increased rotational laxity in the knee with an anterior cruciate ligament injury. Knee 2020, 27(5):1601-1607.
CR  - 14. Liu W, Fu C, Kang K, Huang T, Jiang S, Gu J, Gao S: Evaluation of tibial eminence morphology using magnetic resonance imaging (MRI) in juvenile patients with complete discoid lateral meniscus. BMC Musculoskelet Disord 2022, 23(1):1022.
CR  - 15. Aksahin E, Aktekin CN, Kocadal O, Duran S, Gunay C, Kaya D, Hapa O, Pepe M: Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella. Knee Surg Sports Traumatol Arthrosc 2017, 25(10):3038-3045.
CR  - 16. Cilengir AH, Cetinoglu YK, Kazimoglu C, Gelal MF, Mete BD, Elmali F, Tosun O: The relationship between patellar tilt and quadriceps patellar tendon angle with anatomical variations and pathologies of the knee joint. Eur J Radiol 2021, 139:109719.
CR  - 17. Ali SA, Helmer R, Terk MR: Patella alta: lack of correlation between patellotrochlear cartilage congruence and commonly used patellar height ratios. AJR Am J Roentgenol 2009, 193(5):1361-1366.
CR  - 18. Caton J, Deschamps G, Chambat P, Lerat JL, Dejour H: [Patella infera. Apropos of 128 cases]. Rev Chir Orthop Reparatrice Appar Mot 1982, 68(5):317-325.
CR  - 19. Grelsamer RP, Meadows S: The modified Insall-Salvati ratio for assessment of patellar height. Clin Orthop Relat Res 1992(282):170-176.
CR  - 20. Insall J, Salvati E: Patella position in the normal knee joint. Radiology 1971, 101(1):101-104.
CR  - 21. Cicchetti DV: Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology. Psychological Assessment 1994, 6:284-290.
CR  - 22. Bender R, Lange S: Adjusting for multiple testing--when and how? J Clin Epidemiol 2001, 54(4):343-349.
CR  - 23. Maheshwari SG, Kuber R, Lamghare P, Thomas J, Arkar R, Avhad M, Tharmalingam T, Bhamare DS, Katuri S, Nagraj H et al: Anterior cruciate ligament (ACL) injury: correlation with MRI morphometry. Egyptian Journal of Radiology and Nuclear Medicine 2023, 54(1):130.
UR  - https://doi.org/10.54005/geneltip.1836310
L1  - https://dergipark.org.tr/tr/download/article-file/5479634
ER  -