Differences in Knee Shape between ACL Injured and Non-Injured: A Matched Case-Control Study of 168 Patients.

Koen S.R Van Kuijk,Vincent Eggerding,Max Reijman,Ewoud Van Arkel,Duncan E Meuffels,Jan H Waarsing,Sita M.A Bierma-Zeinstra,Belle L Van Meer

doi:10.3390/jcm10050968

Abstract

Objective: Anterior cruciate ligament (ACL) injury prevention programs could be more effective if we could select patients at risk for sustaining an ACL rupture. The purpose of this study is to identify radiographic shape variants of the knee between patients with and patients without an ACL rupture. Methods: We compared the lateral and Rosenberg view X-rays of 168 prospectively followed patients with a ruptured ACL to a control group with intact ACLs, matched for gender, after knee trauma. We used statistical shape modeling software to examine knee shape and find differences in shape variants between both groups. Results: In the Rosenberg view X-rays, we found five shape variants to be significantly different between patients with an ACL rupture and patients with an intact ACL but with knee trauma. Overall, patients who had ruptured their ACL had smaller, flatter intercondylar notches, a lower lateral tibia plateau, a lower medial spike of the eminence, and a smaller tibial eminence compared to control patients. Conclusion: Patients with an ACL rupture have smaller intercondylar notches and smaller tibial eminences in comparison to patients with an intact ACL after knee trauma.

Highlights

A rupture of the anterior cruciate ligament (ACL) is a common, usually sports-related injury
The purpose of this study is to find radiographic shape variants of the knee between patients with and patients without an ACL rupture, which can be used in daily practice to help select patients with a greater risk for sustaining an ACL rupture
The diagnoses of the included control patients can be found in Table 1, including additional injuries of the ACL ruptured patients

Summary

Introduction

A rupture of the anterior cruciate ligament (ACL) is a common, usually sports-related injury. Rupture of the ACL has immediate consequences resulting in swelling of the knee and pain, and long-term consequences, as there is an almost fourfold risk to progress to moderate or severe radiological osteoarthritis after ten years [5]. In the young population, ACL rupture has a direct impact on sport participation. It has been found, for instance, that after ACL reconstruction, 82% of the patients returned to sport participation; only 63% returned to their preinjury sport level [6,7]. Amongst young patients who return to their pre-trauma sports activity, the prevalence of a re-rupture of their ACL may be as high as 30% [8,9]. Reports show that around 7% of patients need revision ACL surgery and around 3.4% of patients have ACL reconstructions on the contralateral side [10]

Results

Discussion

Conclusion