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MRI Correlation of Anterior Cruciate Ligament Injuries with Femoral Intercondylar Notch, Posterior Tibial Slopes and Medial Tibial Plateau Depth in the Indian Population |
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Ashwini T, Aditi Jain, Ashok Adekal Kumar 1. Junior Resident, Department of Radiodiagnosis, MS Ramaiah Hospitals, Bengaluru, Karnataka, India. 2. Assistant Professor, Department of Radiodiagnosis, MS Ramaiah Hospitals, Bengaluru, Karnataka, India. 3. Professor and Head, Department of Radiodiagnosis, MS Ramaiah Hospitals, Bengaluru, Karnataka, India. |
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Correspondence Address : Dr. Aditi Jain, B-101, M.S Palazzo, 4 91 Jakkur Main Road, Bengaluru-560064, Karnataka, India. E-mail: aditijain11@hotmail.com |
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| ABSTRACT |  | ||||||||||||||||||||||||||||||||||||||||||||||||||||
: Morphometry of body and neural arch of lumbar vertebrae is very crucial in manufacturing screws, interspinous implants as well as preoperative planning of surgeries involving dorsolumbar spine. Aim: To determine various dimensions of typical and atypical lumbar vertebrae. Materials and Methods: A descriptive osteological study was carried out which included 66 intact adult dry human lumbar vertebrae (53 typical and 13 atypical) which were free of any deformity or pathological features. All the 53 typical vertebrae were randomly obtained. The following parameters were measured with slide callipers- superior transverse diameter and superior antero-posterior diameters of vertebral foramen; transverse diameter, antero-posterior diameter and anterior height of vertebral body; width, height of pedicles; interpedicular distance; maximum thickness of lamina; length of transverse process; maximum length, maximum height and maximum central thickness of spinous process. The data was tabulated and analysed using Microsoft Excel software. Mean and standard deviation was calculated for each parameter. Unpaired t-test was applied and p-value was derived for parameters like width and height of pedicles, thickness of lamina and length of transverse process. The p-value<0.05 were considered as significant. Results: The vertebral foramen (superior transverse diameter- 20.41±2.54 mm, superior antero-posterior diameter- 13.3±2.04 mm); vertebral body (transverse diameter- 44.43±5.91 mm, antero-posterior diameter- 30.17±3.19 mm, anterior height- 24.01±1.84 mm); pedicle (width- 10.85±3.94 mm on left side and 11.04±4.01 mm on right side, height- 13.84±4.01 mm on left side and 13.8±1.93 mm on right side, interpedicular distance- 29.17±5.06 mm); lamina (thickness- 6.6±1.36 mm on left side and 6.85±1.34 mm on right side); transverse process (length- 20.94±4.01 mm on left side and 21.51±4.5 mm on right side); spinous process (maximum length- 26.01±3.73 mm, maximum height- 19.92±4.03 mm, maximum central thickness- 6.42±1.41 mm). The mean transverse diameter and antero-posterior diameter of vertebral foramen of atypical lumbar vertebrae were higher than those of the typical lumbar vertebrae and these differences were significant (p-value of 0.0001 for transverse diameter and p-value of 0.005 for antero-posterior diameter). Conclusion: Most of the parameters of atypical lumbar vertebrae were found to be more compared to those of typical lumbar vertebrae. This inference should be kept in mind during fixation of lumbar inter-spinous implants, designing of pedicular screws and spinal grafting. | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Keywords : Anterior cruciate ligament tear, Femoral notch width index, Tibial plateau slope | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| INTRODUCTION |
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Knee is stabilised by a number of ligaments and bones and ACL is one of the most important stabilisers of the knee (1). Many extrinsic and intrinsic factors (2),(3) predispose to ACL injury including width and shape of intercondylar notch of femur, depth of medial tibial plateau and posterior inclination of the medial and lateral tibial plateaus also called as the posterior tibial slope (1). Demographic data with regards to age and gender also show variable predisposition to ACL injury (3). Separate assessment of both plateaus is needed as there can be significant difference in inclination of the two plateaus (4),(5),(6). Narrow femoral intercondylar notch (2), omega shape, increased posterior tibial slopes (2) and shallow medial plateau depth (7) have all shown increased predisposition to ACL injury. The morphology of the intercondylar notch is not only of interest in ACL injury but is also associated with degenerative joint disease and osteochondritis dissecans (8). Shallow medial plateau depth and increased posterior slope result in anterior tibial translation and ACL force in active gait (9). MRI with its superb anatomic detail capability is an excellent tool to evaluate morphology of the femoral notch and the tibial condyles and also to study their relationship with ACL, which it exquisitely visualises. | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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Original article / research
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