Anterior Cruciate Ligament Width Research Articles

Primary anterior cruciate ligament repair—morphological and quantitative assessment by 7-T MRI and clinical outcome after 1.5 years

ObjectivesThe purpose of this study was to assess morphological and quantitative changes of the anterior cruciate ligament (ACL) and cartilage after ACL repair.Methods7T MRI of the knee was acquired in 31 patients 1.5 years after ACL repair and in 13 controls. Proton density-weighted images with fat saturation (PD-fs) were acquired to assess ACL width, signal intensity, elongation, and fraying. T2/T2* mapping was performed for assessment of ACL and cartilage. Segmentation of the ACL, femoral, and tibial cartilage was carried out at 12 ROIs. The outcome evaluation consisted of the Lysholm Knee Score and International Knee Documentation Committee (IKDC) subjective score and clinical examination.ResultsACL showed a normal signal intensity in 96.8% and an increased width in 76.5% after repair. Fraying occurred in 22.6% without having an impact on the clinical outcome (Lysholm score: 90.39 ± 9.75, p = 0.76 compared to controls). T2 analysis of the ACL revealed no difference between patients and controls (p = 0.74). Compared to controls, assessment of the femoral and tibial cartilage showed a significant increase of T2* times in all ROIs, except at the posterolateral femur. Patients presented a good outcome in clinical examination with a Lysholm score of 87.19 ± 14.89 and IKDC of 80.23 ± 16.84.ConclusionT2 mapping results suggest that the tissue composition of the ACL after repair is similar to that of a native ACL after surgery, whereas the ACL exhibits an increased width. Fraying of the ACL can occur without having any impact on functional outcomes. T2* analysis revealed early degradation at the cartilage.Clinical relevance statementMRI represents a noninvasive diagnostic tool for the morphological and compositional assessment of the anterior cruciate ligament after repair, whereas knowledge about post-surgical alterations is crucial for adequate imaging interpretation.Key Points• There has been renewed interest in repairing the anterior cruciate ligament with a proximally torn ligament.• T2 times of the anterior cruciate ligament do not differ between anterior cruciate ligament repair patients and controls.• T2 mapping may serve as a surrogate for the evaluation of the anterior cruciate ligament after repair.

How to predict the dimensions of anterior cruciate ligament in children based on MRI?

There are many studies examining the dimensions of the anterior cruciate ligament (ACL) in children. The correlations between the ACL size in children and other parameters are not well understood. To detect the correlations between the ACL size in children and other parameters including age, gender, bone and soft tissue parameters through measurements on MRI images, and to establish prediction models for the ACL size. A total of 99 patients who underwent MRI scan were included (39 girls, 60 boys; mean age, 13.01 ± 3.94; range of age, 4 to 18). The following measurements were taken on MRI images by 2 observers: ACL length, ACL width, posterior cruciate ligament (PCL) length, the distance from the most anterior aspect of the tibial epiphysis to the anterior aspect of the ACL tibial insertion (AATI), the distance from the most anterior aspect of the tibial epiphysis to the posterior aspect of the ACL tibial insertion (APTI), and the tibial anteroposterior diameter (AP). Correlations between these measurements and the patients' gender and age were investigated, and univariate and multiple linear regression models were established accordingly. Before 13 years old, the ACL length was significantly correlated with the tibial anteroposterior diameter and age (R2 = 0.872, P < .001), and there were no statistically significant gender differences. After 13 years old, the ACL length was significantly correlated with the PCL length and APTI in males (R2 = 0.443, P < .001), and with the PCL length in females (R2 = 0.443, P < .001). In children under 13 years old, there was no significant gender difference in ACL length, and the tibial anteroposterior diameter and age were found to be important indicators in assessing the ACL size. After 13 years old, a significant gender difference in ACL length was observed, and the ACL length was found to be weakly correlated with age and bone parameters. In order to accurately evaluate the ACL size in children aged 13 years and above, it is necessary to refer to the dimensions of the ACL on the collateral side.

Size and Morphology of the Anterior and Posterior Cruciate Ligaments at Different Pediatric Age Intervals: An MRI Analysis.

The incidence of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in children and adolescents has increased over the past decade, with increasing numbers of ACL and PCL reconstructions in this patient population. To evaluate the size and morphology of both the ACL and the PCL by magnetic resonance imaging (MRI) in different pediatric age groups. Cross-sectional study; Level of evidence, 3. MRI examinations of 127 knees (67 female, 60 male; aged 0-18 years) were analyzed retrospectively. The cohort was split into 6 age subgroups, 1 subgroup for every 3 years (minimum 8 patients per subgroup). The following parameters were measured by 2 independent raters at 2 different time points: ACL length, anteroposterior and mediolateral ACL width, sagittal and coronal ACL inclination, inclination of the intercondylar notch, bicondylar width, notch width, coronal ACL and PCL width, PCL length, and sagittal width of the lateral femoral condyle. The following indices, areas, and volumes were calculated: sagittal width of the lateral femoral condyle/PCL length, ACL area and volume, notch width index, ACL width/notch width, PCL width/notch width, ACL width/bicondylar width, and PCL width/bicondylar width. A correlation analysis was performed for patient age, height, weight, and body mass index (BMI). ACL length was between 18 and 37 mm, and ACL width was between 4 and 6 mm. PCL length ranged between 27 and 43 mm, while PCL width was between 7 and 9 mm. Growth of the cruciate ligaments was the most pronounced between the ages of 4 and 12 years. Correlations with size and weight were strong, while BMI correlated slightly with the measurements. Measurements in female patients were slightly larger than in their male counterparts between the ages of 0 and 6 years, while male patients tended to have larger values starting from ages 7 to 9 years. These values were significantly larger in male patients from the ages of 16 to 18 years (P < .05). This study provides normative data on the morphology of pediatric anatomic features in the knee as a basis for age-appropriate and individualized surgical care of ACL and PCL injuries in children and adolescents.

Effect of demographic features on morphometric variables of the knee joint: Sample of a 20 to 40-year-old Turkish population.

This study aimed to investigate the relationship between body mass index (BMI), age, and sex and morphological risk factors that may cause internal knee injuries. The magnetic resonance images of 728 participants who met the inclusion criteria and had a mean age of 34.4 ± 6.8 years were analyzed retrospectively. Demographic differences were analyzed by measuring 17 morphological parameters known to be associated with internal knee injuries. Men had a higher anterior cruciate ligament length (ACLL), anterior cruciate ligament width, (ACLW) lateral femoral condylar width (LFCW), medial femoral condylar width (MFCW), lateral femoral condylar depth (LFCD), distal femoral width (DFW), and intercondylar femoral width (IFW) than women (P < .05). By contrast, the medial meniscus bone angle (MMBA) was lower in men than in women (P < .05). Women aged 31 to 40 years had a lower Insall-Salvati index (ISI) and lateral tibial posterior slope (LTPS) than those aged 21 to 30 years (P < .05), whereas men aged 31 to 40 years had a lower ISI than those aged 21 to 30 years (P < .05). Women with BMI ≥ 30 had a higher LFCW and MFCW but a lower ISI than those with BMI < 30 (P < .05). Men with BMI ≥ 30 had a higher LFCW, MFCW, DFW, and MMBA than those with BMI < 30 (P < .05). The use of value ranges structured according to demographic characteristics, rather than a single value range for all patient groups, may contribute to the evaluation and treatment of the morphological features that are thought to be effective in the development of internal knee injuries. These values may also shed light on future radiological risk scoring systems and artificial intelligence applications in medicine.

Morphometric Analysis of the Anterior Cruciate Ligament

Background: The most often damaged ligament in the knee joint is the anterior cruciate ligament (ACL). Reconstruction surgery is the ideal option which requires morphometric understanding of ACL. The aim of the present study is to determine the length and width of ACL in the knee joint in the South Indian population. Methodology: The study was conducted from August 2020 to July 2021 during a 1-year period. We selected participants with no evident macroscopic abnormalities of the knee joints, between the ages of 27 years and 55 years of both genders. For the study, 50 knee joints from 29 cadavers that fulfilled the above requirements were dissected and the ACL was measured for its length and width in the center point in between bony attachments with digital vernier caliper. Results: The mean length of the ACL was found to be 29.73 mm with standard deviation of 2.32, and the mean width of the ACL was found to be 11.15 mm with standard deviation of 1.07. Conclusion: The present study will add to the existing knowledge on the morphometry of the ACL. This study would be helpful in selecting grafts for surgical reconstruction of the ACL.

Dimensions of the anterior cruciate ligament and thickness of the distal femoral growth plate in children: a MRI-based study.

When determining the dimensions of an anterior cruciate ligament (ACL) graft in children, bone age should be considered in addition to the patient's age, gender, and body height. We aimed to determine the relationship between age, gender, and ACL dimensions as well as thickness of growth plate cartilage of the distal femur during puberty. We retrospectively analyzed MRI scans of the knee in 131 children (82 girls, 49 boys) aged 6-18years (mean age: 14.9 ± 2.6years). ACL length and width as well as thickness of the growth plate cartilage at the distal femoral epiphysis were measured. Mean ACL length increased linearly up to the age of 12years in females and 14years in males; thereafter, mean ACL length remained constant. Mean ACL length was largest at the age of 12 to < 13years (38.18mm) in females and at 15 to < 16years (39.38mm) in males. Mean ACL width increased up to the age of 12years in girls and 13years in boys. After the age of 12years, both the ACL length and width were significantly larger in boys than girls (p = 0.002 and p = 0.045, respectively). Mean thickness of the growth plate cartilage of the distal femur remained stable up to the age of 12years in girls and 14years in boys. Thickness of the growth plate cartilage changed most markedly between the age intervals of 11 to < 12years and 12 to < 13years in girls and between the age intervals of 13 to < 14years and 14 to < 15years in boys. ACL dimensions depended on both age and gender during the growth period. Measurement of cartilage thickness of the femoral distal growth plate proved to be an objective parameter to assess the maturation stage of local bone. This may be useful for the planning and timing of orthopedic ACL procedures. III-retrospective cohort study.

Association between Intercondylar Notch Dimensions and Morphometry of Anterior Cruciate Ligament – A Cadaveric Study

Introduction: Injuries to the anterior cruciate ligament (ACL) are commonly encountered in day-to-day practice. The morphology of the intercondylar notch (ICN), in particular, the width, and shape of the notch are of anatomic interest predisposing to ligament injuries. The previous literature points to contradicting views on the association between ICN dimensions and cruciate ligament injuries. Aim of the study: This study aims to study the morphometry of the ACL and ICN in 32 prosected lower limbs and to see if any association exists between the two. Objectives The objectives of the study were to estimate the dimensions of ACL (maximum length and width) in 32 prosected lower limbs, estimate the dimensions of ICN (ICN width and depth) along with intercondylar (IC) width in 32 prosected lower limbs, and test the strength of association between the dimensions of ICN with the dimensions of ACL. Materials and Methods: The study was done in the Department of Anatomy of MVJ Medical College and Research Hospital, Bengaluru. Thirty-two prosected lower limbs from the department of anatomy were used for the study. Results: It was observed that IC width correlated positively with ACL length as well as ACL width. A strong positive correlation was also observed between IC width with ICN width. Femoral notch width index also correlated positively with ACL width. Conclusions: The above study provides valuable data on the morphometry of ACL and its association with all dimensions of IC fossa unlike previous studies which have correlated the dimensions of IC fossa only with the thickness of ACL.

Patient Height may Predict the Length of the Anterior Cruciate Ligament: A Magnetic Resonance Imaging Study

PurposeThe purpose of this study was to measure the length and width of anterior cruciate ligament (ACL) tibial footprint using magnetic resonance imaging (MRI) and to evaluate correlation between patients’ weight and height with the tibial footprint size.MethodsIn total, 207 eligible patients underwent MRI scanning from June 2018 to June 2020. One hundred seventeen knees from patients aged 18 to 40 years old with intact ACL were included in this study. Data of weight, height, body mass index (BMI) from physical examination and tibial footprint length and width from MRI were obtained. Relationship of ACL tibial footprint length <14 mm and association between ACL tibial footprint sizes of MRI with height, weight, and BMI were analyzed.ResultsThe ACL tibial footprint length and width were, respectively, 11.9 ± 1.8 mm and 10 ± 1.5 mm. Proportion of ACL footprint <14 mm in length was 89.7%. Patient height ≥170 cm was the best predictor of ACL tibial footprint length <14 mm (P = .025). There was a statistically significant relationship between the height of the patients and the length of the ACL tibial footprint. The length of the ACL tibial footprint could be predicted by the formula: length = −7.362 + 11.48 × (height in meters).ConclusionThe height of the patients may predict the length of the ACL tibial footprint. Although patient’s age, sex, and BMI correlate poorly with ACL tibial footprint width, there was no correlation between patient’s weight and ACL tibial footprint size.Clinical RelevanceBefore ACL reconstruction surgery, an estimation of ACL tibial footprint size might aid in the graft harvesting preparation.

Anthropometric study as a predictor of anterior cruciate ligament sizes in Asian Indonesian population.

To evaluate whether anthropometric data can predict anterior cruciate ligament (ACL) sizes on magneti resonance imaging (MRI) in Asian population. Reconstruction of ACL has been performed over a decade ago. Recently, more individualized ACL reconstruction is performed taking account of each patient's ACL characteristics. However, there has been limited study regarding ACL sizes in Asian Indonesian population. This study aimed to evaluate the role of anthropometric data in ACL sizes using MRI in Asian Indonesian population. Retrospective Study. A series of 531 knees from 420 patients with knee pain and intact ACL confirmed by MRI study. Length, width and inclination angle of ACL were measured using a T2-weighted sagittal MRI 3.0 Tesla Magnetom Skyra. Height, weight, body mass index (BMI) and age were recorded. Multiple regression analysis was used to determine relationship between the anthropometric data and size of ACL measurements. ACL length and width were significantly different between male and female, consecutively. Mean ACL length was 35.36 ± 3.63 mm, male was significantly longer (36.59 ± 3.24 mm) compared to female (32.77 ± 2.99 mm), p < 0.0001. Mean ACL width was 10.23 ± 1.84 mm, male was significantly wider (10.85 ± 1.59 mm) compared to female (8.93 ± 1.64 mm), p < 0.0001. The mean ACL inclination angle was 47.75° ± 3.07° (range 40.17°-57.12°). The strongest correlation for ACL length was height and weight (r = 0.437; r = 0.341 consecutively, p < 0.0001). Females had stronger correlation compared to males for ACL length (R2 = 0.489 vs R2 = 0.418). ACL width showed weak correlation with anthropometric data. The following regression analysis equation was obtained for ACL length: ACL length = 60.697 - 0.11*age + 0.461*weight (kg) - 16.522*height (meter) - 1.093*BMI (R2 = 0.539; p < 0.0001). Anthropometric data can be utilized as a predictor of ACL length in Asian Indonesian population. The ACL length in Asian Indonesian population is shorter than that in Western population study.

Sex Comparisons of In Vivo Anterior Cruciate Ligament Morphometry.

Females have consistently higher anterior cruciate ligament (ACL) injury rates than males. The reasons for this disparity are not fully understood. Whereas ACL morphometric characteristics are associated with injury risk and females have a smaller absolute ACL size, comprehensive sex comparisons that adequately account for sex differences in body mass index (BMI) have been limited. To investigate sex differences among in vivo ACL morphometric measures before and after controlling for femoral notch width and BMI. Cross-sectional study. Laboratory. Twenty recreationally active men (age = 23.2 ± 2.9 years, height = 180.4 ± 6.7 cm, mass = 84.0 ± 10.9 kg) and 20 recreationally active women (age = 21.3 ± 2.3 years, height = 166.9 ± 7.7 cm, mass = 61.9 ± 7.2 kg) participated. Structural magnetic resonance imaging sequences were performed on the left knee. Anterior cruciate ligament volume, width, and cross-sectional area measures were obtained from T2-weighted images and normalized to femoral notch width and BMI. Femoral notch width was measured from T1-weighted images. We used independent-samples t tests to examine sex differences in absolute and normalized measures. Men had greater absolute ACL volume (1712.2 ± 356.3 versus 1200.1 ± 337.8 mm3; t38 = -4.67, P < .001) and ACL width (8.5 ± 2.3 versus 7.0 ± 1.2 mm; t38 = -2.53, P = .02) than women. The ACL volume remained greater in men than in women after controlling for femoral notch width (89.31 ± 15.63 versus 72.42 ± 16.82 mm3/mm; t38 = -3.29, P = .002) and BMI (67.13 ± 15.40 versus 54.69 ± 16.39 mm3/kg/m2; t38 = -2.47, P = .02). Whereas men had greater ACL volume and width than women, only ACL volume remained different when we accounted for femoral notch width and BMI. This suggests that ACL volume may be an appropriate measure of ACL anatomy in investigations of ACL morphometry and ACL injury risk that include sex comparisons.

Morphology of Intra-articular Structures and Histology of Menisci of Knee Joint.

Introduction:Menisci and cruciate ligaments are intra-articular structures of knee, and injury to these structures is common. Morphometric data gained in the study will help in analyzing the variations among humans and correlating it with the possibility, location, and type of injuries as well as better interpretation of structures during magnetic resonance imaging and arthroscopy which will further help in reconstructive surgeries of knee.Materials and Methods:Width and thickness of the medial menisci (MM), lateral menisci (LM), and maximum length and width of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were taken on twenty knees. Histological examination of menisci was done.Results:Width of MM was 0.601–0.700 cm at anterior horn (AH) in 45% of cases, 1.000–1.500 cm at posterior horn (PH) in 60% of cases, and 1.000-1.500 cm at body in 30% of cases. Thickness of MM at AH (45%) and PH (40%) was 0.401–0.500 cm and at body (35%) was 0.501–0.600 cm. Width of LM at AH (35%) was 0.801–0.900 cm, at PH (45%) was 0.901–1.000 cm, and at body (35%) was 1.000–1.500 cm. Thickness of LM at AH (45%) was 0.301–0.400 cm, at PH (50%) was 0.401–0.500 cm, and at body (40%) was 0.601–0.700 cm. Length of ACL in maximum percentage of specimens (55%) was 3.01-3.50 cm. Width of ACL in 25% specimens were 0.801-0.900 cm and in another 25% specimens were 1.001-1.500 cm. Length of PCL in maximum percentage of specimens ( 50 %) was 3.51-4.00 cm. Width of PCL in 80 % of specimens was 1.001-1.500 cm. Histological examination of menisci showed fibrocartilage (outer two-thirds) and hyaline cartilage (inner one-third). Orientation of fibers was circumferential with intermingled radial fibers. Fibroblasts, chondrocytes, and unclassified cells were arranged as single, paired, or in rows along the direction of fibers except in hyalinized part. Blood vessels were present toward the peripheral part.Conclusions:The maximum width of MM was at PH and for LM it was at the body. Maximum thickness was at the body for MM as well as LM. Width of PCL was more as compared to ACL.

Association of Anterior Cruciate Ligament Width With Anterior Knee Laxity.

Greater anterior knee laxity (AKL) has been identified as an anterior cruciate ligament (ACL) injury risk factor. The structural factors that contribute to greater AKL are not fully understood but may include the ACL and bone geometry. To determine the relationship of ACL width and femoral notch angle to AKL. Cross-sectional study. Controlled laboratory. Twenty recreationally active females (age = 21.2 ± 3.1 years, height = 1.66.1 ± 7.3 cm, mass = 66.5 ± 12.0 kg). Anterior cruciate ligament width and femoral notch angle were obtained with magnetic resonance imaging of the knee and AKL was assessed. Anterior cruciate ligament width was measured as the width of a line that transected the ACL and was drawn perpendicular to the Blumensaat line. Femoral notch angle was formed by the intersection of the line parallel to the posterior cortex of the femur and the Blumensaat line. Anterior knee laxity was the anterior displacement of the tibia relative to the femur (mm) at 130 N of an applied force. Ten participants' magnetic resonance imaging data were assessed on 2 occasions to establish intratester reliability and precision. Using stepwise backward linear regression, we examined the extent to which ACL width, femoral notch angle, and weight were associated with AKL. Strong measurement consistency and precision (intraclass correlation coefficient [2,1] ± SEM) were established for ACL width (0.98 ± 0.3 mm) and femoral notch angle (0.97° ± 1.1°). The regression demonstrated that ACL width (5.9 ± 1.4 mm) was negatively associated with AKL (7.2 ± 2.0 mm; R(2) = 0.22, P = .04). Femoral notch angle and weight were not retained in the final model. A narrower ACL was associated with greater AKL. This finding may inform the development of ACL injury-prevention programs that include components designed to increase ACL size or strength (or both). Future authors should establish which other factors contribute to greater AKL in order to best inform injury-prevention efforts.

Clinical anatomy of the anterior cruciate ligament and pre-operative prediction of ligament length

BACKGROUND: Ligament grafts used in anterior cruciate ligament (ACL) reconstruction need to be the correct length for proper functioning. If the graft length is incorrect, the patient could risk knee instability, loss of range of motion, or failure of graft fixation. Easier and time-efficient reconstruction will be facilitated if the length of the ACL is predicted in advance. Apart from examining the morphological properties of the ACL, this study aimed to determine whether the epicondylar width of an individual can be used to predict ACL length and thereby assist in restoring the normal anatomy of the ACL. METHODS: Ninety-one adult cadavers were studied. Patellar ligament (PL) length, ACL length, ACL width and the maximum femoral epicondylar width (FECW) were measured. RESULTS: The morphology of the ACL and PL was determined. The results revealed that FECW was the most reliable predictor of ACL length. A linear regression formula was developed in order to determine ACL length by measuring maximum FECW. CONCLUSIONS: ACL and PL morphology compared well with the results found in previous studies. An individual's FECW can be used to predict ACL length pre-operatively. These results could improve pre-operative planning of ACL reconstruction.

Risk assessment for anterior cruciate ligament injury.

Anterior cruciate ligament tears are one of the most frequent soft tissue injuries of the knee. A torn anterior cruciate ligament leaves the knee joint unstable and at risk for further damage to other soft tissues manifested as pain, dislocation, and osteoarthritis. A better understanding of the anatomical details of knee joints suffering anterior cruciate ligament tears is needed to understand and develop prediction models for anterior cruciate ligament injury and/or tear. Magnetic resonance images of 32 patients with anterior cruciate ligament tears and 40 patients with non-tears were evaluated from a physician group practice. Digital measurements of femoral condyle length, femoral notch width, anterior cruciate ligament width in the frontal and sagittal plane, and the anterior cruciate ligament length in the sagittal plane were taken in both groups to identify trends. Monte Carlo simulations were performed (n=2000) to evaluate the relationship between notch width index and sagittal width and to establish functional relationships among the anatomical parameters for potential injury risk. Sensitivity analysis performed shows the risk of anterior cruciate ligament injury a function of force and notch width index. Females have a significantly shorter anterior cruciate ligament when compared to that of males. The notch width index was also significantly different between torn and non-torn individuals. The NWI was not significantly different between genders (p value=0.40). Anterior cruciate ligament injury has been shown to be caused by the forces which act on the ligament. These forces can result from hyperextension of the tibia or the internal rotation of tibia. The anatomical parameters of the knee joint (i.e., notch width index, anterior cruciate ligament width and length) have no role in the cause of an injury.

Morphometry and magnetic resonance imaging of anterior cruciate ligament and measurement of secondary signs of anterior cruciate ligament tear

Injuries or over-stretching of the anterior cruciate ligament (ACL) may lead to its malfunctioning. ACL tear, partial or complete, canto the result of contact or non-contact injuries. To conduct morphometry of ACL, twenty six knees (14 right and 12 left) were examined in 21 male and 5 female formalin fixed cadavers. Measurement of tibial foot print of ACL, distance of its anterior edge from the anterior margin of tibia, length and width of ACL were determined with the help of digital caliper. Indirect signs of ACL tear (sagittal ACL-tibial angle, coronal ACL - tibial angle, Blumensaat line - ACL angle and angle of inclination of the intercondylar roof) complement the magnetic resonance imaging (MRI) diagnosis of ACL injury. We also studied the consequences of meniscal and posterior cruciate ligament injuries on above mentioned angles. In addition 84 MRI images of knees of patients aged between 18 - 74 years were evaluated for diagnosis of any disruption in the morphology of ACL. In our study, mean length of the tibial foot print of ACL was 18.34 ± 3.49 mm, mean width of tibial foot print was 15.26 ± 2.01, mean distance from the anterior edge of tibia to anterior margin of attachment of ACL was 13.11 ± 2.34, length and width of ACL were 32.5 ± 4.33 mm and 9.38 ± 1.58 mm, respectively. The present study will be useful for enhancing the knowledge of anatomy of ACL and may act as a valuable guide for radiologists in evaluating the injury to knee involving ACL, menisci and PCL (Tab. 5, Fig. 9, Ref. 17). anterior cruciate ligament, magnetic resonance imaging, posterior cruciate ligament, meniscus, tibia, tear, injury.

Correlation between the morphometric parameters of the anterior cruciate ligament and the intercondylar width: gender and age differences

The study was conducted on 50 cadavers (32 male and 18 female, aged 15-53 years; mean 34; SD 11) with intact anterior cruciate ligament (ACL), without diagnosed gonarthrosis of the knee joint. The following anatomical parameters of the ACL were measured: the length of anteromedial and posterolateral bundle, the mean length and the width of the ligament, the length and width of tibial insertion, the length and width of femoral insertion. The intercondylar width was measured at the level of popliteal groove. The width of male intercondylar notch (22 mm) was statistically significantly greater (P < 0.05) than the width of female intercondylar notch (18 mm). The width of the male ACL (12 mm) was significantly greater (P < 0.05) than the width of the female ACL (10 mm). The length of the male ACL femoral insertion (14 mm) was statistically significantly greater (P < 0.05) than in the female ACL femoral insertion (12 mm). Accordingly, with greater width of intercondylar notch, men have wider ACL than women. ACL width is in positive correlation with the male intercondylar notch width but it is not in correlation with the female intercondylar notch width. The width of male intercondylar notch correlates with the length and width of ACL femoral insertion. Taking into account the length and width of femoral insertion in examined cadaver knees, double bundle reconstruction would theoretically be possible in 76% of cases.

Correlation of the intercondylar notch width of the femur to the width of the anterior and posterior cruciate ligaments.

The purpose of this study was to determine if a correlation exists between the intercondylar notch width (NW) of the femur and the width of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). A study group of 124 consecutive patients (mean age 36.6 +/- 15.2 years; 67 men, 57 women) underwent a magnetic resonance imaging evaluation for knee pain but did not have an ACL or PCL tear or arthrosis. A T2 weighted coronal cut was identified and was located at the middle of the tibial spine, which represented the plane where the ACL and PCL cross each other when the knee is in 10 degrees of flexion. The NW and the width of the ACL and PCL were measured at the level of the middle of the popliteal hiatus on a physician-independent console that allowed for digital measurements in millimeters. Our results showed a statistically significant correlation between NW and ACL width (r = 0.87; P < 0.001) and between NW and PCL width (r = 0.75; P < 0.001). The mean ACL width was 6.4 +/- 1.4 mm (range 3-10 mm). The mean PCL width was 10.2 +/- 2.0 mm (range 6-17 mm). The mean ACL width was 5.7 +/- 1.1 mm for women and 7.1 +/- 1.2 mm for men (P < 0.001). The mean PCL width was 9.5 +/- 1.7 mm for women and 10.9 +/- 2.0 for men (P < 0.001). Our results indicate that NW correlates with ACL and PCL width. In addition, ACL and PCL widths are narrower in women than men.