DOI: 10.4103/aam.aam_490_26 ISSN: 1596-3519

Magnetic Resonance Imaging-based Intrinsic Anatomical Parameters as Predictors of Anterior Cruciate Ligament Injury and Graft Failure: A Comparative Case–control Study

Nairuti Mahesh Patel, Santosh R Konde, Sambhaji Pawal

Abstract

Context:

Anterior cruciate ligament (ACL) injuries are common knee injuries associated with significant morbidity and risk of long-term osteoarthritis. Despite advances in the reconstruction techniques, graft failure still remains a clinical challenge. Intrinsic anatomical factors measurable on magnetic resonance imaging (MRI) may predispose individuals to both primary ACL injury and reconstruction failure.

Aims:

To evaluate MRI-derived anatomical risk factors – posterior tibial slope (PTS), tibial tubercle–trochlear groove (TT–TG) distance, and intercondylar notch morphology and width – in ACL injury and graft failure, compared with controls.

Settings and Design:

Retrospective case–control study at a tertiary academic center in Western India.

Subjects and Methods:

One hundred adults undergoing knee MRI were grouped as ACL tear ( n = 40), graft failure ( n = 20), and controls ( n = 40). Measurements included PTS, TT–TG distance, and notch width index (NWI) with morphology.

Statistical Analysis Used:

Continuous variables were compared using the one-way analysis of variance. Categorical variables were compared using Chi-square/Fisher’s exact test.

Results:

PTS was higher in ACL injury and graft failure (11.78°, 13.95°) versus controls (10.74°). TT–TG distance was increased (15.34 mm, 15.40 mm vs. 12.44 mm). NWI was lower (0.184, 0.198 vs. 0.228). V-shaped notch was more frequent but not independently significant.

Conclusions:

Increased PTS, TT–TG distance, and reduced NWI are the significant risk factors for ACL injury and graft failure.

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