A narrow intercondylar gap favours anterior cruciate ligament (ACL) rupture in patients with an immature skeleton

L Silva; N Bernal; M Tuca; M Espinosa; G de la Fuente

doi:10.1016/j.recot.2020.08.004

A narrow intercondylar gap favours anterior cruciate ligament (ACL) rupture in patients with an immature skeleton

Rev Esp Cir Ortop Traumatol (Engl Ed). 2021 May-Jun;65(3):201-206. doi: 10.1016/j.recot.2020.08.004. Epub 2021 Jan 15.

[Article in English, Spanish]

Authors

L Silva¹, N Bernal², M Tuca², M Espinosa², G de la Fuente²

Affiliations

¹ Clínica Alemana Santiago, Universidad del Desarrollo, Santiago, Chile. Electronic address: lorettosilva@gmail.com.
² Clínica Alemana Santiago, Universidad del Desarrollo, Santiago, Chile.

PMID: 33455882
DOI: 10.1016/j.recot.2020.08.004

Abstract

Objective: Anatomical risk factors predisposing to anterior cruciate ligament (ACL) and/or avulsion fractures of tibial spines (AFET) have been reported in paediatric patients with controversial results. Our aim is to compare morphometric parameters in magnetic resonance imaging (MRI) of patients with immature skeleton presenting AFET or ACL rupture versus healthy controls.

Methods: Observational study of a transverse cohort where all those patients with immature skeleton presenting ACL rupture or AFET were collected consecutively. A control group of patients with open physis and MRI reported without lesions was added. A trained observer measured in each MRI with previously standardized technique: a)the width of the intercondylar femoral notch, and b)the opening angle of the intercondylar femoral notch.

Results: The sample was composed of 11 patients with ACL rupture, 11 patients with TEA and 11 normal controls. The opening angle of the intercondylar femoral notch, measured in axial and coronal sections, was significantly lower in those patients with ACL rupture versus healthy controls (P=.0256 and P=.0097). The rest of the variables studied did not present significant differences between groups.

Conclusion: In patients with an immature skeleton, a narrower femoral intercondylar notch is associated with ACL rupture, while those with an ETF do not present a distinctive bone anatomy versus healthy controls. These findings suggest that bone morphometric parameters are associated with a lesional or other pattern in open-knee.

Keywords: Anterior cruciate ligament; Esqueléticamente inmaduro; Fractura de espinas tibiales; Ligamento cruzado anterior; Paediatric; Pediátrico; Skeletally immature; Tibial spine fracture.