Abstract
PurposeTo compare the anterior translation and internal rotation of tibia on magnetic resonance imaging (MRI) between adult and adolescent patients with anterior cruciate ligament (ACL) tears.MethodsPatients who underwent isolated ACL reconstruction from January 2013 to May 2021 were retrospectively reviewed. The exclusion criteria included incomplete data, poor image quality, a prior ACL surgery, and concomitant fractures or other ligament injuries. The enrolled patients were divided into two groups based on their ages: an adult group (age > 19 years) and an adolescent group (15 to 19 years of age). Anterior tibial translation and femorotibial rotation were measured on MRI. A Student’s t-test was used for the statistical analysis comparing the adult and adolescent groups.ResultsA total of 365 patients (279 adults and 86 adolescents) were enrolled in the present study. The anterior tibial translation in the adult group (4.8 ± 4.4 mm) and the adolescent group (5.0 ± 4.2 mm) was not significantly different (p = 0.740). On the other hand, the tibial internal rotation in the adult group (5.6 ± 5.0 degree) was significantly greater compared to the adolescent group (4.2 ± 5.6 degree) (p = 0.030). The intraclass correlation coefficients (ICC) of the measured data from two independent observers showed excellent reliability (0.964 and 0.961 for anterior tibial translation and tibial internal rotation, respectively).ConclusionThe adult patients with ACL tears exhibited significant greater tibial internal rotation compared to the adolescent patients, whereas the magnitude of the anterior tibial translation was similar in both groups. Care should be taken if clinicians plan to establish the cutoff point values for diagnosis of ACL tears using the femorotibial internal rotation angle.
Highlights
In addition to the integrity of the anterior cruciate ligament (ACL) itself, several additional signs have been proposed that can assist with the diagnosis of ACL tears on magnetic resonance imaging (MRI), including anterior tibial translation [7, 8], internal rotation of the tibia [6], the lateral femoral notch sign [9, 10], and bone kissing contusions [10, 11]
Numkarunarunrote et al indicated that anterior tibial translation was significantly greater in patients with complete ACL tear compared to patients with intact ACL [8]; they provided cutoff point distances of 3.5 mm and 5.5 mm for diagnosis of partial and complete ACL tears, respectively
It was considered that the cutoff point distances for diagnosis of ACL tear established from adult patients [8] may possibly be appropriate for adolescent patients
Summary
The anterior cruciate ligament (ACL) is a structure that contributes to the restraints of anterior translation and internal rotation of the tibia relative to the femur [1,2,3,4,5,6].In addition to the integrity of the ACL itself, several additional signs have been proposed that can assist with the diagnosis of ACL tears on magnetic resonance imaging (MRI), including anterior tibial translation [7, 8], internal rotation of the tibia [6], the lateral femoral notch sign [9, 10], and bone kissing contusions [10, 11].Several studies have indicated that ACL-deficient knees feature static instability parameters on MRI [4, 6, 8, 12]. The anterior cruciate ligament (ACL) is a structure that contributes to the restraints of anterior translation and internal rotation of the tibia relative to the femur [1,2,3,4,5,6]. In addition to the integrity of the ACL itself, several additional signs have been proposed that can assist with the diagnosis of ACL tears on magnetic resonance imaging (MRI), including anterior tibial translation [7, 8], internal rotation of the tibia [6], the lateral femoral notch sign [9, 10], and bone kissing contusions [10, 11]. The magnitude of tibial rotation on MRI in patients with ACL tears has been evaluated. Vassalou et al demonstrated an increase in tibial internal rotation in adult patients with ACL tear [6], whereas Mitchell et al found a greater internal tibial rotation in adolescent ACL-deficit knees [4]
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