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Analysis of the intercondylar notch by computed tomography
A F Anderson1, A B Lipscomb, K J Liudahl
1Department of Orthopedic Surgery and Rehabilitation, St. Thomas Hospital, Nashville, Tennessee.
The American Journal of Sports Medicine
|November 1, 1987
Summary
Narrower intercondylar notches are associated with anterior cruciate ligament (ACL) tears. This study found significant differences in notch dimensions between normal and ACL-injured knees, recommending notch-plasty for stenosis.
Area of Science:
- Orthopedic Surgery
- Radiology
- Sports Medicine
Background:
- Anterior cruciate ligament (ACL) tears are common knee injuries.
- Intercondylar notch stenosis may be a predisposing factor for ACL tears.
- Understanding notch morphology is crucial for injury prevention and treatment.
Purpose of the Study:
- Document intercondylar notch dimensions in normal knees.
- Compare normal knees to those with ACL tears to identify associations with stenosis.
- Investigate the link between generalized ligamentous laxity, notch stenosis, and ACL tears.
Main Methods:
- Comparison of three groups: bilateral ACL tears, unilateral ACL tears, and normal knees.
- Computer-generated notch dimensions from CT scans.
- Assessment of ligamentous laxity in all patients.
Main Results:
- Statistically significant differences in notch dimensions (opening angle, width ratios) between normal and ACL-injured knees.
- Evidence suggests an association between anterior outlet stenosis and ACL tears.
- Narrow notches were often wave-shaped, requiring further investigation.
Conclusions:
- Intercondylar notch stenosis is significantly associated with ACL tears.
- Recommended surgical intervention (notch-plasty) for documented stenosis.
- Specific dimensional guidelines provided: notch width to condyle width ratio > 0.2 and opening notch angle > 50 degrees.