Analysis of the intercondylar notch by computed tomography.
The purposes of this study were to document the dimensions and configuration of the intercondylar notch in the normal knee; to compare normal knee intercondylar notches to those of knees with unilateral and bilateral ACL tears to determine if there is a relationship between intercondylar notch stenosis and ACL tears; and to determine if generalized ligamentous laxity is associated with intercondylar notch stenosis and ACL tears. Three groups were compared: Group I, bilateral ACL tears; Group II, unilateral tears; and Group III, normal knees. Notch dimensions were computer-generated from CT scans. All patients were examined for ligamentous laxity. Statistically significant differences were found between normal and ACL-injured knees in regard to opening notch angle, ratio of notch width at two-thirds of the notch length to condylar width, and ratio of maximum notch width to condylar width, suggesting a significant association between anterior outlet stenosis and unilateral and bilateral ACL tears. The shapes of the notches were determined from tracings of the distal CT scan. Shapes ranged from inverted U to cresting wave. Narrow notches tended to be waveshaped, but more study is needed in this area. Notch-plasty is recommended for those with documented stenosis. The ratio of maximum notch width at two-thirds of the notch height to maximum condyle width should not be much less than 0.2, and the opening notch angle should be at least 50 degrees.
Department of Orthopedic Surgery and Rehabilitation, St. Thomas Hospital, Nashville, Tennessee.
A F
AF
Anderson
A B
AB
Lipscomb
K J
KJ
Liudahl
R B
RB
Addlestone
D000328:Adult; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D007717:Knee / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D007718:Knee Injuries / Q000150:complications / Q000000981:diagnostic imaging; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D012016:Reference Values; D012421:Rupture; D014057:Tomography, X-Ray Computed