A Study on the Morphometric Dimensions of the Intercondylar Notch of the Femur Using Computed Tomography/Magnetic Resonance Imaging and Its Clinical Significance
B. Santhosh Kumar, M. Praveen, Muvvala Ganesh Kumar, Ravichandran DoraiswamyIntroduction:
Anterior cruciate ligament (ACL) injury is the most common cause of knee instability, with the geometry of the femoral intercondylar notch recognized as a critical anatomical determinant. Narrower notches have been implicated in higher susceptibility to ACL rupture and in technical difficulties during ligament reconstruction. Despite extensive literature, data from South Asian populations remain limited, and variations across ethnic groups highlight the need for region-specific normative values derived from advanced imaging modalities.
Objectives:
The present study aimed to establish magnetic resonance imaging (MRI)-based normative morphometric values for the intercondylar notch in a South Indian cohort and to evaluate potential laterality differences. By providing population-specific standards, the study sought to enhance clinical risk stratification and surgical planning in ACL-related pathology.
Methodology:
A retrospective analysis of 144 knee MRI studies was performed after the institutional ethics committee approval. Measurements obtained included bicondylar width (BCW), intercondylar notch width (ICN W), intercondylar notch depth (ICN D), notch roof angle (NRA), notch width index (NWI), and ACL length (in intact ligaments). Standardized anatomical landmarks on sagittal, axial, and coronal sequences were used for assessment. Statistical comparisons between right and left knees were undertaken using independent samples
Results:
The cohort demonstrated mean (±standard deviation) values of BCW 66.82 ± 6.53 mm, ICN W 17.46 ± 3.49 mm, ICN D 21.04 ± 5.56 mm, NRA 50.31° ±6.70°, ACL length 30.10 ± 3.14 mm, and NWI 0.253 ± 0.037. No statistically significant side-to-side differences were observed for any parameter. The derived indices closely paralleled prior Indian literature, when showing proportional narrowing compared with Western cohorts.
Conclusion:
This study establishes normative MRI-based morphometric parameters of the femoral intercondylar notch in a South Indian population. Documented differences compared with Western data underscore the importance of demographic context in ACL risk assessment and reconstructive planning. These findings provide a crucial reference for clinical decision-making and support future multicenter studies in diverse populations.