MRI Correlation of Anterior Cruciate Ligament Injuries with Femoral Intercondylar Notch, Posterior Tibial Slopes and Medial Tibial Plateau Depth in the Indian Population

• Main Authors: Ashwini T, Aditi Jain, Ashok Adekal Kumar
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2018-07-01
• Series: International Journal of Anatomy Radiology and Surgery
• Subjects: anterior cruciate ligament tear; femoral notch width index; tibial plateau slope
• Online Access: http://www.ijars.net/article_fulltext.asp?issn=0973-709x&year=2018&month=July&volume=7&issue=3&page=RO01-RO06&id=2397

Introduction: Injuries to the Anterior Cruciate Ligament (ACL) of the knee are common. Many anatomical factors like width and shape of intercondylar notch of femur, the posterior tibial slopes of the plateaus and depth of medial tibial plateau predispose to ACL tear. MRI evaluates these parameters and studies their relationship with ACL injury. Aim: To study and correlate femoral intercondylar notch width and shape, posterior tibial slopes of medial and lateral plateaus and depth of the medial tibial plateau with ACL injury on MRI. Materials and Methods: A retrospective study of 100 patients who underwent MRI knee in Department of Radio diagnosis, MS Ramaiah Hospitals, Bengaluru, India - 50 patients had no ACL injury (Group A), and fifty had ACL injury on MRI (Group B). Demographic data was also collected. Notch width index (NWI) and notch shape (Inverted U, A and Ω) were assessed on T2 Fat suppressed coronal sequences. Posterior Tibial Slopes (PTS) of medial and lateral plateaus and medial tibial plateau depth measured on sagittal reconstructed images of 3D PD coronal SPACE sequences. Statistical analysis was done and p-value and odds ratios calculated. Results: Omega (Ω) shaped notch and Narrow femoral NWI were statistically significant in patients with ACL tear and latter measured 0.29 ± 0.02. NWI was significant in females and in age group of 31-45 years. Increased Medial Tibial Plateau Slope (MTPS) was significant with a p-value of 0.008 and measured 7.2 ± 3.7°. Decreased Medial Tibial Plateau Depth (MTPD) was not significant. Odds ratio showed males had more predilections for ACL tear. Increased MTPS and LTPS were more than two times associated with tear. Ω as compared to A showed 7.2 times more predilection. MTPD of less than 2.12 mm was predictive of ACL tear. Conclusion: Low NWI and Ω shape of the femoral notch predisposed to ACL tear. Increased posterior tibial slope of medial plateau and shallow medial tibial plateau also predisposed to ACL tear