Association Between Lateral Femoral Condyle Height and Depth Ratio, Medial Tibial Plateau Slope, and Isolated...

The morphological features of the femoral condyles have recently attracted attention as a potential risk factor for knee injuries. However, little is known about whether the femoral condylar morphology is related to posterior cruciate ligament (PCL) injury.

To investigate whether the morphological characteristics of the femoral condyle are risk factors for isolated PCL rupture.

Case-control study; Level of evidence, 3.

From the patients who visited the outpatient clinic of our hospital between 2012 and 2022, we included 78 patients with isolated PCL ruptures and 78 age- and sex-matched controls with knee injury but no structural damage evident on magnetic resonance imaging (MRI). The following parameters were assessed using MRI: the lateral femoral condyle and medial femoral condyle height and depth ratio (LFC-H/D, MFC-H/D), notch width index, intercondylar notch angle, the lateral tibial plateau slope, and medial tibial plateau slope (MTPS), and medial tibial depth. Values were compared between these 2 groups using the independent t test and the Mann-Whitney U test. Univariate logistic regression analysis was subsequently performed to identify independent risk factors. Receiver operating characteristic curves were generated for the morphological indicators and the combination of risk factors.

Patients in the isolated PCL rupture group had significantly lower LFC-H/D (0.49 vs 0.52; P < .001) and MTPS (7.34 vs 8.81; P = .012) values compared with the control group. In sex-specific analyses, both male and female patients with isolated PCL rupture had a significantly lower LFC-H/D (female patients: 0.46 vs 0.52; P < .001; male patients: 0.51 vs 0.52; P = .035). In addition, male patients with PCL rupture had a smaller MTPS (6.74 mm vs 8.79 mm; P = .004). Univariate logistic regression analysis further validated LFC-H/D (odds ratio [OR], <0.001; P < .001) and MTPS (OR, 0.889; P = .014) as risk factors for isolated PCL rupture.

A decreased LFC-H/D and a reduced MTPS were identified as risk factors for isolated PCL rupture. Sex-specific analysis further suggested that a decreased LFC-H/D was a risk factor for isolated PCL ruptures in both male and female patients, whereas a lower MTPS was a risk factor exclusively in male patients.