Adult patients with ACL tears have greater tibial internal rotation in MRI compared to adolescent patients

J Orthop Surg Res. 2022 Jan 11;17(1):17. doi: 10.1186/s13018-022-02912-0.

Abstract

Purpose: To compare the anterior translation and internal rotation of tibia on magnetic resonance imaging (MRI) between adult and adolescent patients with anterior cruciate ligament (ACL) tears.

Methods: Patients who underwent isolated ACL reconstruction from January 2013 to May 2021 were retrospectively reviewed. The exclusion criteria included incomplete data, poor image quality, a prior ACL surgery, and concomitant fractures or other ligament injuries. The enrolled patients were divided into two groups based on their ages: an adult group (age > 19 years) and an adolescent group (15 to 19 years of age). Anterior tibial translation and femorotibial rotation were measured on MRI. A Student's t-test was used for the statistical analysis comparing the adult and adolescent groups.

Results: A total of 365 patients (279 adults and 86 adolescents) were enrolled in the present study. The anterior tibial translation in the adult group (4.8 ± 4.4 mm) and the adolescent group (5.0 ± 4.2 mm) was not significantly different (p = 0.740). On the other hand, the tibial internal rotation in the adult group (5.6 ± 5.0 degree) was significantly greater compared to the adolescent group (4.2 ± 5.6 degree) (p = 0.030). The intraclass correlation coefficients (ICC) of the measured data from two independent observers showed excellent reliability (0.964 and 0.961 for anterior tibial translation and tibial internal rotation, respectively).

Conclusion: The adult patients with ACL tears exhibited significant greater tibial internal rotation compared to the adolescent patients, whereas the magnitude of the anterior tibial translation was similar in both groups. Care should be taken if clinicians plan to establish the cutoff point values for diagnosis of ACL tears using the femorotibial internal rotation angle.

Keywords: Anterior cruciate ligament; Anterior tibial translation; Tibial internal rotation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament
  • Anterior Cruciate Ligament Injuries / diagnostic imaging*
  • Anterior Cruciate Ligament Injuries / surgery
  • Anterior Cruciate Ligament Reconstruction*
  • Female
  • Humans
  • Joint Instability*
  • Knee Joint / surgery
  • Magnetic Resonance Imaging / instrumentation*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Reproducibility of Results
  • Retrospective Studies
  • Tibia / diagnostic imaging
  • Young Adult