MEAN INTERCONDYLAR NOTCH
WIDTH INDEX IN MALES WITH AND
WITHOUT ANTERIOR CRUCIATE
LIGAMENT TEAR.
IRIA - 1112
Aim
 To compare intercondylar notch width in male patients with
and without anterior cruciate ligament tear.
Materials and Methods
 120 male patients, who were referred to the Department of
Radiology from December 2013 to October 2014 were
included in the study.
 We included only male patients as there is significant
morphometric difference in the bones between male and
female patients.
 Axial, coronal and sagittal magnetic resonance imaging was
performed using Hitachi Aperto machine with the patient's
knee in extended position.
 54 patients with normal anterior cruciate ligament were used
as control and 66 patients with a complete or incomplete
tear of anterior cruciate ligament were chosen as case group.
 Only male patients within the age range of 17 to 55 years
were included in the study and patients with osteoarthritic
changes were excluded.
 In all patients, the femoral notch width and the bicondylar
width were measured on axial images at the level of the
popliteal groove. The notch width index was then calculated.
a
b
Sagittal and axial magnetic resonance images showing normal anterior
cruciate ligament in a 21 year old male patient with notch width index of
0.312.
a
b
Sagittal and axial images in a 47 year old male patient showing anterior
cruciate ligament tear with narrow intercondylar notch and notch width
index of 0.251.
b
a
Sagittal and axial images in a 31 year old male patient showing complete tear
of the anterior cruciate ligament with narrow intercondylar notch and notch
width index of 0.259.
Series 1
0.3
0.29
0.28
0.27
Series 1
0.26
0.25
0.24
Patients with
ACL tear
Patients without
ACL tear
Results
 The 120 patients who were included in the study were
between the age 17 to 55 years.
 The mean notch width index in male patients with anterior
cruciate ligament injury (0.261) was lesser in comparison to
the patients with no anterior cruciate ligament injury
(0.296).
 The P value was found to be less than 0.05 using Student’s T
test.
Discussion
 The anterior cruciate ligament (ACL), one of the major
intracapsular knee ligaments, is located in the intercondylar notch
of femur.
 Cranially it is attached to the postero-medial surface of the lateral
femoral condyle and caudally to the anterior part of the
intercondylar region of the tibia.
 Injuries to the knee joint are fairly common and the anterior
cruciate ligament is the most frequently injured knee ligament.
Anterior cruciate ligament injuries can lead to significant
morbidity.
 Numerous procedures have been devised to treat anterior
cruciate ligament tears. However, there is no ideal
replacement for a normal anterior cruciate ligament .
 It has been hypothesized that a narrow intercondylar notch
predisposes to anterior cruciate ligament injury.
 Palmer et al, Anderson et al, LaPrade and Burnett, Ireland et
al, Shelbourne et al, Lund-Hanssen et al, Souryal et al and
more have conducted many studies that concluded that
femoral notch stenosis is associated with increased incidence
of anterior cruciate ligament tears.
 Our study also found similar results. The notch width index
in male patients with anterior cruciate ligament tear was
comparatively smaller than the patients without tear.
 This suggests that the size of the notch width can be a
predictor in assessing the risk factor for anterior cruciate
ligament injury.
Conclusions
 In conclusion, we postulate that a smaller notch width index
is associated with the risk of anterior cruciate ligament
rupture.
 Magnetic resonance imaging measurement was proven to be
effective, and radiologists need to be more cautious when
observing and diagnosing patients with small notch width and
notch width index.
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