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1.
Knee Surg Sports Traumatol Arthrosc ; 30(1): 102-108, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34283249

RESUMO

PURPOSE: Smaller femoral intercondylar notch volume has been identified as a risk factor for anterior cruciate ligament injury. The present study aims to investigate differences in the intercondylar notch volume based on differences in the morphology of Blumensaat's line. METHODS: Eighty-eight (88) subjects (42 male and 46 female: median age 27: range 15-49), were included in this study. Using 3-dimensional computed tomography (3D-CT), the volume of the intercondylar notch was calculated using a truncated-pyramid shape simulation with the formula: [Formula: see text]. Femoral condyle height (h) was measured in the sagittal plane of the knee in 3D-CT. The area of the intercondylar notch was measured in the axial slice containing the most proximal level (S1) and most distal level (S2) of Blumensaat's line. In the sagittal view of the knee, Blumensaat's line morphology was classified into either straight or hill type. Statistical analysis was performed to compare h, S1, S2, and notch volume between the straight and hill type groups. RESULTS: Thirty-six subjects were classified as having straight type morphology and 52 subjects were classified as having hill type morphology. The measured h, S1, and S2, of the straight and hill types were 29 ± 4 and 31 ± 4 mm, 213 ± 72 and 205 ± 51 mm2, 375 ± 114 and 430 ± 94 mm2, respectively. The calculated femoral intercondylar notch volume of the straight and hill types was 8.1 ± 2 and 9.5 ± 2 cm3, respectively. Straight type knees showed significantly smaller S2 (p = 0.04), and notch volume (p = 0.01) when compared with hill type knees. CONCLUSION: Intercondylar notch volume was significantly smaller in knees with straight type Blumensaat's line morphology. Considering that Blumensaat's line represents the roof of the femoral notch, morphological variations in Blumensaat's line are likely to reflect variation in notch volume. For clinical relevance, as a smaller notch volume is a risk factor for ACL injury, straight type Blumensaat's line may also be considered a potential risk factor for ACL injury. LEVEL OF EVIDENCE: Level III.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Adulto , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/cirurgia , Feminino , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Masculino , Tomografia Computadorizada por Raios X
2.
Knee Surg Sports Traumatol Arthrosc ; 30(10): 3322-3327, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35201373

RESUMO

PURPOSE: The purpose of this study was to investigate the correlation between femoral intercondylar notch volume and the characteristics of femoral tunnels in anatomical single bundle anterior cruciate ligament (ACL) reconstruction. METHODS: Fifty-one subjects (24 male and 27 female: median age 27: range 15-49), were included in this study. Anatomical single bundle ACL reconstruction was performed in all subjects using a trans-portal technique. Femoral tunnel length was measured intra-operatively. Three-dimensional computed tomography (3D-CT) was taken at pre and post-surgery. The intercondylar notch volume was calculated with a truncated-pyramid shape simulation using the pre-operative 3D-CT image. In the post-operative 3D-CT, the modified quadrant method was used to measure femoral ACL tunnel placement. RESULTS: Femoral tunnel placement was 47.6 ± 10.5% in the high-low (proximal-distal) direction, and 22.6 ± 5.4% in the shallow-deep (anterior-posterior) direction. Femoral tunnel length was 35.3 ± 4.4 cm. Femoral intercondylar notch volume was 8.6 ± 2.1cm3. A significant correlation was found between femoral intercondylar notch volume and high-low (proximal-distal) femoral tunnel placement (Pearson's coefficient correlation: 0.469, p = 0.003). CONCLUSION: Femoral ACL tunnel placement at a significantly lower level was found in knees with large femoral intercondylar notch volume in the trans-portal technique. For the clinical relevance, although the sample size of this study was limited, surgeons can create femoral ACL tunnel low (distal) in the notch where close to the anatomical ACL footprint in the knees with large femoral intercondylar notch volume. LEVEL OF EVIDENCE: III.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Articulação do Joelho , Adulto , Reconstrução do Ligamento Cruzado Anterior/métodos , Feminino , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Imageamento Tridimensional , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Masculino , Tomografia Computadorizada por Raios X
3.
Knee Surg Sports Traumatol Arthrosc ; 29(6): 1709-1713, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32761277

RESUMO

PURPOSE: The purpose of this study was to measure the femoral intercondylar notch volume using a truncated-pyramid shape simulation and compare this volume between anterior cruciate ligament (ACL) injured and intact subjects. METHODS: Forty-seven subjects diagnosed with ACL tear by MRI (22 male and 25 female: median age 26: range 15-49), and 41 subjects in which knee MRI was performed and no ACL injury detected (20 males and 21 females: median age 27: range 16-49), were included in this study. Using three-dimensional computed tomography (3D-CT), the axial femoral intercondylar notch area was measured in the slice containing the most proximal (S1) and most distal (S2) level of Blumensaat's line. Femoral condyle height (h) was measured using a sagittal view of knees in 3D-CT. The truncated-pyramid shape simulation was calculated as: Volume = [Formula: see text]. Statistical analysis was performed to compare S1, S2, notch height, and notch volume between the ACL-injured and intact groups. RESULTS: The measured S1, S2, and the notch height of the ACL-injured and intact groups were 201 ± 64 and 214 ± 50mm2, 370 ± 91 and 461 ± 94mm2, and 31 ± 3 and 30 ± 4mm, respectively. The calculated femoral intercondylar notch volume of the ACL-injured and intact groups was 8.6 ± 2.2 and 9.9 ± 2.6cm3, respectively. The ACL intact group showed significantly larger S2 and notch volume when compared with the ACL-injured group. CONCLUSION: For clinical relevance, notch volume and most distal axial notch area parameters were significantly larger in ACL intact subjects. The truncated-pyramid shape simulation is an easy and cost-effective method to evaluate intercondylar notch volume. In knees with small femoral intercondylar notch volume, attention is needed to prevent ACL injury. LEVEL OF EVIDENCE: Level III.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Fêmur/diagnóstico por imagem , Adolescente , Adulto , Ligamento Cruzado Anterior/diagnóstico por imagem , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/economia , Análise Custo-Benefício , Feminino , Fêmur/cirurgia , Humanos , Imageamento Tridimensional/métodos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
4.
Knee Surg Sports Traumatol Arthrosc ; 28(7): 2105-2115, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32157364

RESUMO

PURPOSE: The aim of this study was to determine if a difference exists in the relationship between the femoral intercondylar notch volume, and the volumes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in ACL injured patients and healthy subjects. METHODS: Intact knees of 19 healthy subjects and bilateral knees of 18 ipsilateral ACL reconstructed patients were scanned using 3-tesla high-resolution magnetic resonance imaging. The intercondylar notch, ACL, PCL and hamstring graft were segmented using three-dimensional (3D) processing software. The native intercondylar notch, ACL, and PCL volumes were compared between both groups. The volumes of native ACL and graft were compared in ACL injured patients. RESULTS: The following volumes showed no significant differences between the ACL injured group and control group; intercondylar notch (9.9 ± 2.3 vs 9.6 ± 1.7 cm3), ACL (2.4 ± 0.7 vs 2.4 ± 0.6 cm3) and PCL (3.9 ± 1.0 vs 3.4 ± 0.8 cm3), and the ratio of the ACL to the intercondylar notch (24.6 ± 5.0 vs 25.4 ± 2.9%). There was a significant difference in the ratio of PCL to the intercondylar notch (39.1 ± 4.3 vs 35.9 ± 4.9%, p = 0.023). The graft was significantly larger than native ACL volume (3.0 ± 0.7 vs 2.4 ± 0.7 cm3, p = 0.012). CONCLUSIONS: The ratio of the PCL volume in the femoral intercondylar notch was higher in the ACL injured group compared to the healthy control group, despite the ratio of ACL volume in the femoral intercondylar notch being similar in both groups. A greater awareness of the potentially limited space for the graft alongside the PCL within the femoral intercondylar notch may allow surgeons a more informed choice of graft type and size. LEVEL OF EVIDENCE: IV.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Ligamento Cruzado Anterior/cirurgia , Articulação do Joelho/fisiologia , Adolescente , Adulto , Reconstrução do Ligamento Cruzado Anterior , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética/métodos , Masculino , Adulto Jovem
5.
J Orthop Surg Res ; 17(1): 560, 2022 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-36550563

RESUMO

BACKGROUND: Two relatively common forms of injury exist in the posterior cruciate ligament (PCL) after the onset of trauma: PCL tear and tibial avulsion fracture. The mechanism for the occurrence of these different forms of injury is not known. Herein, we aimed to investigate this mechanism by comparing the intercondylar notch parameters between patients with PCL tears and those with PCL avulsion fractures of the tibial insertion. METHODS: Fifty-three patients with PCL tears (37 male, 16 female: median age of 37 years: range 18-54 years) and 46 patients with avulsion fractures of tibial insertion (33 male, 13 female: median age of 33 years: range 18-55 years) were included in this study. Three-dimensional computed tomography (CT) was applied to measure the intercondylar notch width index and intercondylar notch volume. The intercondylar notch volume was simulated as the truncated-pyramid shape. Measurements of the top and bottom areas of this model were conducted on the slice containing the most proximal (S1) and most distal (S2) levels of Blumensaat's line. Femoral condyle height (h) was defined as the vertical distance between two parallel planes, and the volume was calculated as h(S1 + S2 + √(S1S2))/3. The values of S1, S2, h, notch volume, the body mass index (BMI), intercondylar notch width (NW), femoral condylar width (FW) and notch width index (NWI) were compared among the PCL tear and avulsion-fracture groups. RESULTS: The results show a significant difference in the S2 and normalized intercondylar notch volumes among patients with PCL tears and tibial avulsion injuries. Patients with PCL tears have smaller S2 and intercondylar notch volumes than those with tibial avulsion. There were no significant differences between the two groups in S1 or the 2D notch measurement parameters, such as the NW, FW and NWI. In addition, logistic regression analysis revealed notch volume and body mass index (BMI) as two significant independent predictors for PCL tears. CONCLUSION: Decreased intercondylar notch volume and increased BMI are associated with an increased incidence of PCL tears. The occurrence of PCL tears and tibial avulsion injuries is influenced by the femoral intercondylar notch volume, and the measurement of the notch volume could be useful for identifying patients at risk for PCL tears.


Assuntos
Lesões do Ligamento Cruzado Anterior , Fratura Avulsão , Traumatismos do Joelho , Ligamento Cruzado Posterior , Lesões dos Tecidos Moles , Entorses e Distensões , Fraturas da Tíbia , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Ligamento Cruzado Posterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/complicações , Imageamento por Ressonância Magnética/métodos , Articulação do Joelho , Traumatismos do Joelho/diagnóstico por imagem , Fêmur , Tomografia Computadorizada por Raios X , Entorses e Distensões/complicações , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/complicações
6.
Indian J Orthop ; 56(2): 327-337, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35140865

RESUMO

PURPOSE: To determine the relationship between femoral-tibial morphometries and anterior cruciate ligament (ACL) pathologies using magnetic resonance imaging (MRI). METHODS: We retrospectively evaluated 455 patients (211 females and 244 males) who underwent knee MRI with suspected ACL pathology. Imaging findings were classified as normal ACL (n = 119), degeneration of the ACL (n = 116), partial ACL tear (n = 103), and complete ACL tear (n = 117). In all groups, the femoral intercondylar notch width (INW), intercondylar distance (CD), notch width index (NWI), and intercondylar notch angle (INA), the angles between the tibial plateau and tibial spines (MPA and LPA), intercondylar eminence peak angle (IEA), and tibial slope angles (MSA and LSA) were measured. RESULTS: Femoral INW and NWI were significantly lower in patients with ACL pathology (p < 0.05). They were also lower in patients with tear compared to degeneration. The INA was significantly smaller in patients with ACL pathology (p < 0.001) and the significance continued in both genders. The LSA was only increased in patients with complete tear (p < 0.01) and the difference seems existing in both genders. It was also found that the LPA and IEA demonstrated significant increases in patients with ACL pathology (p < 0.01 and < 0.05, respectively) and the significance in LPA continued in both genders. Significant differences between males and females were found for the INW and CD in all 4 groups (p < 0.001). In addition, the INA, LPA and LSA were independent predictors in determining the risk of ACL pathology. CONCLUSION: The ACL pathologies are associated with femoral-tibial morphometries and these associations exist in both genders. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43465-021-00490-7.

7.
Clin Orthop Surg ; 14(1): 76-89, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35251544

RESUMO

BACKGROUND: Stenotic femoral intercondylar notch is considered as a risk factor for anterior cruciate ligament (ACL) injury and three-dimensional notch volume is used as a marker for the injury. The primary purpose of this study was to assess the difference in notch volume between the ACL-injured and uninjured in men and women combined or stratified by sex. The secondary purpose was to assess the difference in notch volume between the ACL-intact men and women. METHODS: A search of PubMed/Medline, Scopus, Google Scholar, and Cochrane databases from inception to December 9, 2020, was conducted without restrictions using the following terms: ACL, notch, volume, notch volume, femoral notch volume, and intercondylar notch volume. Studies that compared the ACL-injured with uninjured controls were included. Independent extraction of articles by two authors using predefined data fields including study quality indicators was done. All pooled analyses were based on the inverse-variance weighted random effects model and mean difference was chosen as the effect measure. RESULTS: Nine studies (1,169 knees) qualified for overall analysis (both sexes combined) and significant heterogeneity was observed, which disappeared after pooling studies with age-sex matched controls and those without. Notch volume in the ACL-injured was 0.75 cm3 (95% confidence interval [CI], 0.53-0.96 cm3), which was smaller than that in the age- and sex-matched controls. Six studies qualified for analysis in men. Notch volume in the ACL-injured men was smaller, especially when non-contact ACL injury was considered (1.40 cm3; 95% CI, 1.08-1.73 cm3). Five studies qualified for analysis in women and ACL-injured women had smaller notch volume irrespective of the mechanism of injury (0.38 cm3; 95% CI, 0.18-0.59 cm3). Notch volume of the uninjured men was larger than that of the uninjured women (1.86 cm3; 95% CI, 1.54-2.18 cm3). CONCLUSIONS: ACL-injured adults have smaller notch volume than the age- and sex-matched controls. Non-contact ACL-injured males have smaller notch volume compared to ACL-intact males. ACL-injured females have smaller notch volume irrespective of the nature of injury. Men have higher notch volume than women. The quality of evidence is very low to low.


Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior , Adulto , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Feminino , Fêmur/diagnóstico por imagem , Humanos , Articulação do Joelho , Imageamento por Ressonância Magnética , Masculino , Fatores de Risco
8.
J Clin Med ; 10(5)2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33801168

RESUMO

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.

9.
Bone Joint J ; 101-B(9): 1058-1062, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474133

RESUMO

AIMS: Little is known about the risk factors that predispose to a rupture of the posterior cruciate ligament (PCL). Identifying risk factors is the first step in trying to prevent a rupture of the PCL from occurring. The morphology of the knee in patients who rupture their PCL may differ from that of control patients. The purpose of this study was to identify any variations in bone morphology that are related to a PCL. PATIENTS AND METHODS: We compared the anteroposterior (AP), lateral, and Rosenberg view radiographs of 94 patients with a ruptured PCL to a control group of 168 patients matched by age, sex, and body mass index (BMI), but with an intact PCL after a knee injury. Statistical shape modelling software was used to assess the shape of the knee and determine any difference in anatomical landmarks. RESULTS: We found shape variants on the AP and Rosenberg view radiographs to be significantly different between patients who tore their PCL and those with an intact PCL after a knee injury. Overall, patients who ruptured their PCL have smaller intercondylar notches and smaller tibial eminences than control patients. CONCLUSION: This study shows that differences in the shape of the knee are associated with the presence of a PCL rupture after injury. A smaller and more sharply angled intercondylar notch and a more flattened tibial eminence are related to PCL rupture. This suggests that the morphology of the knee is a risk factor for sustaining a PCL rupture. Cite this article: Bone Joint J 2019;101-B:1058-1062.


Assuntos
Traumatismos do Joelho/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Ligamento Cruzado Posterior/lesões , Tíbia/diagnóstico por imagem , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Traumatismos do Joelho/etiologia , Articulação do Joelho/anatomia & histologia , Masculino , Pessoa de Meia-Idade , Ligamento Cruzado Posterior/diagnóstico por imagem , Fatores de Risco , Ruptura , Tíbia/anatomia & histologia
10.
Springerplus ; 5(1): 1164, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27512623

RESUMO

INTRODUCTION: Hoffa fractures are rare and difficult to treat for orthopaedic surgeons. The mechanism of injury of Hoffa fracture is still unknown and the operation approch and fixation method are still controversial. The aim of this study is to compare the clinical effect between two fixation methods on Hoffa fractures. CASE DESCRIPTION: From April 2004 to July 2013, we treated eleven patients (new method group) with Hoffa fracture using the new fixation method (fixed with intercondylar screw and crossed screws) and sixteen patients (traditional method group) using the traditional fixation method (fixed with anteroposteriorly placed screws). All documents from their admission until the last followup in December 2015 were reviewed, data regarding complications collected and results were evaluated using the Knee Society Score. DISCUSSION AND EVALUATION: After an average follow-up period of 27.1 months (range 24-32 months), all fractures had healed. The average healing time of the new method group was 11.36 weeks (range 9-14 weeks) and the average healing time of the traditional method group was 11.88 weeks (range 9-14 weeks). According to the Knee Society Score, the average score of the new method group was 176.36 points (range 125-199 points), and the average score of the traditional method group was 171.19 points (range 148-197 points). Statistical analysis (t test, t = 0.76, P > 0.05) showed that the difference of both the healing time (t test, t = 0.94, P > 0.05) and the score between these two groups was not significant. CONCLUSIONS: These results indicate that the new fixation method for Hoffa fracture is as effective as the traditional method and may provide a new way to treat Hoffa fractures.

11.
Exp Ther Med ; 11(4): 1275-1278, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27073436

RESUMO

The knee joint is extremely susceptible to injury, which is usually identified by magnetic resonance imaging (MRI). In the present study, MRI was applied to quantitatively detect the association between anterior cruciate ligament (ACL) rupture and anatomic morphologic changes of the intercondylar notch. Forty patients with unilateral ACL rupture who were treated between July, 2013 and October, 2014 were enrolled in the present study. The patients were divided into the observation (affected side) and control (healthy side) groups. MRI measurements were undertaken based on parameters associated with intercondylar notch of double knee joints. The results showed that intercondylar notch width (ICW) in the observation group was significantly smaller than that in the control group, and differences were statistically significant (P<0.05). Differences on the intercondylar notch height and femoral condyle width [epicondylar width (EW)] between the two groups were not statistically significant (P>0.05). Notch width index (NWI) and notch shape index (NSI) in the observation group were significantly less than those in the control group and differences were statistically significant (P<0.05). Differences of Lysholm and Tegner scoring between the two groups were not statistically significant (P>0.05). The differential value of ICW in the observation group was 2.6±1.3 mm and the ACL rupture time of the affected knee was 20.4±1.3 months on average. The correlation was statistically significant (P<0.05). The correlation of Lysholm scoring, Tegner scoring and intercondylar notch stenosis degree on the affected knee was not statistically significant (P>0.05). In conclusion, after ACL rupture, ICW on the affected knee had significant stenosis, NSI and NWI were significantly reduced and the stenosis degree was aggravated with the prolongation of course. By contrast, Lysholm and Tegner scoring of patients with different degrees of stenosis had no correlation.

12.
Am J Sports Med ; 42(8): 1796-805, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24866891

RESUMO

BACKGROUND: The morphometric characteristics of the anterior cruciate ligament (ACL) and the femoral intercondylar notch within which it resides have been implicated as risk factors for injuries to this important stabilizer of the knee. Prior research has produced equivocal results with differing methodologies, and consequently, it is unclear how these characteristics affect the injury risk in male and female patients. HYPOTHESIS: The morphometric characteristics of the ACL and femoral intercondylar notch are individually and independently associated with the risk of suffering a noncontact ACL injury, and these relationships are different in male and female patients. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: Magnetic resonance imaging scans of the bilateral knees were obtained on 88 case-control pairs (27 male, 61 female) matched for age, sex, and participation on the same sports team. Patients had suffered a grade III, first-time, noncontact ACL tear. The femoral notch width at 4 locations, the thickness of the bony ridge at the anteromedial outlet of the femoral notch, the femoral notch volume, ACL volume, and ACL cross-sectional area were measured. RESULTS: Multivariate analysis of combined data from male and female patients revealed that decreased ACL volume (odds ratio [OR], 0.829), decreased femoral notch width (OR, 0.700), and increased bony ridge thickness at the anteromedial outlet of the femoral notch (OR, 1.614) were significant independent predictors of an ACL injury. Separate analyses of male and female patients indicated that the femoral notch ridge may be more strongly associated with a risk in female patients, while ACL volume is more strongly associated with a risk in male patients. However, statistical analysis performed with an adjustment for body weight strengthened the association between ACL volume and the risk of injuries in female patients. CONCLUSION: Morphometric features of both the ACL and femoral notch combine to influence the risk of suffering a noncontact ACL injury. When included together in a multivariate model that adjusts for body weight, the effects of the morphometric measurements are similar in male and female patients. If body weight is not taken into consideration, ACL volume is not associated with a risk in female patients.


Assuntos
Lesões do Ligamento Cruzado Anterior , Fêmur/patologia , Traumatismos do Joelho/patologia , Articulação do Joelho/patologia , Peso Corporal , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Análise Multivariada , Estudos Prospectivos , Fatores de Risco
13.
Eur J Trauma Emerg Surg ; 39(1): 87-91, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26814927

RESUMO

PURPOSE: To investigate the clinical effect of a new fixation method for Hoffa fractures. METHODS: We treated eleven patients with Hoffa fracture using the new fixation method (fixation with one screw inserted from the femoral intercondylar notch and two screws inserted from the nonarticular lateral (or medial) surface of the fractured condylar fragment; the two sets of screws were crossed). RESULTS: After an average follow-up period of 24 months (range 5-28 months), all fractures had healed. The average healing time was 11.6 weeks (range 9-14 weeks). On the version of the Knee Society Score modified by Dr. John Insall in 1993, the average score was 174.6 points (range 125-199 points). CONCLUSIONS: The new fixation method for Hoffa fracture is effective, and may provide a new way to treat Hoffa fractures.

14.
Artigo em Chinês | WPRIM | ID: wpr-432545

RESUMO

Objective To summarize clinical features and explore diagnosis and treatment of femoral intercondylar notch non-bony impingement syndrome. Methods 15 patients of femoral intercondylar notch non-bony impingement syndrome were identified during arthroscopic operation of 115 patients (120 knees) with restricted knee joint extention during Oct 2004 to Dec 2007. Among these 15 patients, there were 3 cases of Bucket Handle Tear(BHT), 1 case of ACL's cyst, 3 cases of ACL tibial avulsion injury, 3 cases of synovial incarceration, and 5 cases of synovial chondroma. 9 patients were diagnosed by MRJ and 2 by X-ray before operation. All 15 patients were confirmed under arthroscopy. Results 15 patients( 15 knees) were operated and followed up for a period of 4~24 months, mean 13 months. Mean Lysholm score was 65(range, 41~75) before operation and 89(range, 75~100) after operation. Joint extension restrict was 5~25 degrees (mean 8.1 degree) before operation and 0 degree after operation. Conclusion Arthroscopy could accurately diagnose femoral Intercondylar notch non-bony impingement syndrome. Pre-operation MRI was helpful for diagnosis. If MRI and X-ray showed negative findings, diagnostic arthroscopic examination could be applied. Good subjective and objective effects could be achieved with arthroscopic operation.

15.
Artigo em Coreano | WPRIM | ID: wpr-730404

RESUMO

PURPOSE: The purpose of this study was to evaluate the relationship between the femoral intercondylar notch width (ICW), the posterior tibial slope angle (PTS), rupture of the anterior cruciate ligament (ACL) and the ruptured site. MATERIALS AND METHODS: We retrospectively reviewed 105 cases of ruptured ACL (105 patients), and 91 cases of intact ACL (91 patients). The ICW and PTS were measured from the plain knee radiographs. The ratio of the ICW and the femoral intercondylar notch height (ICH) was also measured. As for the site of ACL rupture, the patients with a ruptured ACL were divided into 3 groups (group 1: femoral attach site, 2: mid-substance, 3: tibial attach site), and the correlations between the ICW and the PTS of each group were analyzed. RESULTS: The mean ICW of the ACL ruptured group was 15.51+/-4.30 mm (95% confidence interval: 15.48~15.53), that of the ACL intact group was 24.49+/-3.86 mm (24.47~24.52), and the mean PTS of the ruptured ACL group was 7.68+/-3.78degrees (7.65~7.70) and that of the intact ACL group was 6.12+/-3.85degrees (6.10~6.13). A narrow ICW was a significant risk factors for ACL rupture (odds ratio=0.661 [0.602~0.720], p<0.01). But we did not get any statistically significant results for the increase PTS (odds ratio=1.073 [1.062~1.134], p=0.197). According to the ruptured site, the analysis of variance of the ICW and PTS had no significant correlation. CONCLUSION: A narrow ICW is a significant risk factor for ACL rupture.


Assuntos
Humanos , Ligamento Cruzado Anterior , Joelho , Estudos Retrospectivos , Fatores de Risco , Ruptura
16.
Artigo em Coreano | WPRIM | ID: wpr-730468

RESUMO

PURPOSE: The purpose of this study is to evaluate the possible relationship between femoral intercondylar notch stenosis and ACL injury according to gender with retrospective analysis of knee MRI. MATERIALS AND METHODS: The study was based on 260 cases of knee MRI (except the cases of combined colleteral ligaments injury and fracture) between the ages of 18 and 50 years from March 1995 to March 2001. All cases were divided into three groups : group 1 consisted of knees 94 cases that were nor-mal, group 2 consisted of knees from 72 cases that had a contact ACL injury, group 3 consisted of knees from 92 cases that had a non contact ACL injury. We measured the notch height, notch width at the point of 1/3, 2/3 of notch height, notch angle, lateral angle with coronal section. Each measurements of three groups were compared with gender and for statistical significance using the ANOVA test. RESULTS: The mean notch angle was 48.2 +/-6.7 degrees for men and 47.1 +/-1.2 degrees for women in group 1, 48.7 +/- 6.5 degrees for men and 48.7 +/-1.2 degrees for women in group 2, 47.4 +/-6.5 degrees for men and 47.3 +/-1.5 degrees for women in group 3. The mean notch width at the point of 1/3, 2/3of notch height were 18.6 +/-2.4 mm, 15.3 +/-2.4 mm for men and 16.9 +/-2.4 mm, 14.2 +/-2.4 mm for women in group 1, 18.2 +/-2.4 mm, 15.2 +/-2.4 mm for men and 16.7 +/-2.4 mm, 13.9 +/-2.4 mm for women in group 2, 16.8 +/-2.4 mm, 13.9 +/-2.4 mm for men and 15.7 +/-2.4 mm, 13.4 +/-2.4 mm for women in group 3. Statistically significant differences were found between sexes in group 3 in regard to notch width at the point of 1/3, 2/3 of notch height, notch angle(<0.05). CONCLUSION: Stenosis of femoral intercondylar notch may be a factor of ACL injury. So preoperative measurement of femoral intercondylar notch may be necessary to determine the amount of notchplasty degree in ACL reconstruction.


Assuntos
Feminino , Humanos , Masculino , Constrição Patológica , Articulação do Joelho , Joelho , Ligamentos , Imageamento por Ressonância Magnética , Estudos Retrospectivos
17.
Artigo em Chinês | WPRIM | ID: wpr-554459

RESUMO

0.05). The notch width index was 0.24?0.05. There was no correlation between the notch width index and the height (r=-0.11), the body weight (r=-0.13), and the age (r=-0.28). Conclusion The notch-view radiographs with 45? flexion of the knee can satisfactorily show the shape and the width of the intercondylar notch. The notch width and the notch width index of the normal knee are (18.9?4.8) mm and 0.24?0.05, respectively. The height and the body weight can′t be used to predict the notch width. The study supplies the radiographic basis for the diagnosis and treatment of the diseases related with the femoral intercondylar notch.

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