Biomarkers that Can Predict the Diagnosis of an Anterior Cruciate Ligament Injury on MR Images, Preoperatively

PURPOSE OF THE STUDY The competence of the anterior translation of tibia (ATT), posterior cruciate ligament angle (PCLA), and femorotibial rotation angle (FTRA) measured on MR images in predicting anterior cruciate ligament (ACL) injury was evaluated in this study. MATERIAL AND METHODS 266 patients who underwent diagnostic arthroscopy between 2015-2020 were included in this study. Age, gender, radiological fi ndings included ATT, PCLA, and FTRA were measured on preoperative MR images of all patients. RESULTS ACL tear was detected in 143 of patients and most of them were younger males. In ACL-R group, the ATT was 7 mm (-4-17 mm), PCLA value was 110º (52º-157º), and FTRA value was 5.8º (-5º-18º), while in ACL-I group, the ATT was approximately 5 mm (-4-12 mm), PCLA value was 122º (82º-162º) and FTRA value was 1.6º (-10.9º-10º) (p<0.001). ROCCurve test results showed that if ATT value was >6.05 mm (63% sensitivity, 65% specifi city) if PCLA value was <116.5º (65% sensitivity, 70% specifi city) and if FTRA value was >3.45º (73% sensitivity, 72% specifi city), these parameters could predict the probability of ACL tear, preoperatively. The Logistic Regression test results revealed that the PCLA and FTRA values could be the best markers to predict the probability of ACL tear, preoperatively. CONCLUSIONS This study results showed that the ATT, PCLA, and FTRA values could be used as predictive markers in diagnosis of ACL tear, preoperatively. Among these three values, it was concluded that the FTRA could have the highest sensitivity and specifi city ratios and the best predictive value. Key words: anterior cruciate ligament tear, magnetic resonance imaging, arthroscopy, rotational instability, femorotibial rotation angle, anterior translation of the tibia, posterior cruciate ligament angle.