Relationship between Femoral Intercondylar Notch Narrowing in Radiography and Anatomical and Histopathologic Integrity of Anterior Cruciate Ligament in Patients Undergoing Total Knee Replacement Surgery

Hosseinali Hadi; Ali Rahbari; Mahmood Jabalameli; Abolfazl Bagherifard; Ahmadreza Behrouzi; Fatemeh Safi; Zahra Rezaei; Gholamreza Azarnia Samarin; Amir Azimi

Relationship between Femoral Intercondylar Notch Narrowing in Radiography and Anatomical and Histopathologic Integrity of Anterior Cruciate Ligament in Patients Undergoing Total Knee Replacement Surgery

Arch Bone Jt Surg. 2019 Nov;7(6):523-530.

Authors

Hosseinali Hadi^{1

2

3

4

5

6}, Ali Rahbari^{1

2

3

4

5

6}, Mahmood Jabalameli^{1

2

3

4

5

6}, Abolfazl Bagherifard^{1

2

3

4

5

6}, Ahmadreza Behrouzi^{1

2

3

4

5

6}, Fatemeh Safi^{1

2

3

4

5

6}, Zahra Rezaei^{1

2

3

4

5

6}, Gholamreza Azarnia Samarin^{1

2

3

4

5

6}, Amir Azimi^{1

2

3

4

5

6}

Affiliations

¹ Orthopedic Department, Arak University of Medical Sciences, Arak, Iran.
² Pathology Department, Arak University of Medical Sciences, Arak, iran.
³ Bone and Joint Reconstruction Research Center, Shafa Yahyaian Hospital, Iran university of Medical Science, Tehran, Iran.
⁴ Valiasr Hospital, Arak University of Medical Sciences, Arak, Iran.
⁵ Radiology Department, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
⁶ Research performed at Bone and Joint Reconstruction Center, Vali-Asr Hospital, Arak University of Medical Science, Arak, Iran.

PMID: 31970257
PMCID: PMC6935521

Abstract

Background: The presence of cruciate ligaments is very important for normal knee kinematics. Knee arthroplasty prostheses, in which these ligaments are maintained, have better kinematics. The aim of the present study was to investigate the association between femoral intercondylar notch (FIN) narrowing in radiography and clinical and histopathologic integrity of anterior cruciate ligament (ACL) in patients undergoing knee replacement surgery.

Methods: FIN index was measured in tunnel view radiography of the knees of 102 candidates of knee replacement surgery. The anatomical status of ACL was also examined during total knee arthroplasty (TKA). ACL was removed and sent for histopathologic examination to assess its degeneration rate. The association between the FIN index and the clinical and histopathological health of ACL was investigated.

Results: Among 102 patients with mean age of 69.73 ± 7.81 years , 39 patients (38.32%) had no or torn ACL, 31 patients (30.39%) had weak ACL, and 32 (31.37%) had normal ACL. There was a significant association between age and clinical status of ACL during surgery (P=0.017). There was a significant difference in FIN and ACL health status during surgery between the two groups with an index of more and less than 0.252 (P=0.019 and P=0.019, respectively). There was no significant difference in the mean total degeneration score (TDS) of ACL between the two groups with FIN more and less than 0.252 (P=0.816).

Conclusion: There was a significant difference between the age and FIN narrowing (less than 0.252) as well as ACL clinical status during surgery. FIN narrowing had no significant effect on the severity of ACL degeneration and there was no significant difference in the severity of degenerative histopathologic changes between healthy and attenuated ACLs. This indicates that if ACL exists, although apparently attenuated, it has the histologic characteristic of a healthy ligament.

Keywords: emoral intercondylar notch; nee arthroplasty; nterior cruciate ligament.