title: Risk assessment for anterior cruciate ligament injury.
abstract: BACKGROUND
  Anterior cruciate ligament tears are one of the most frequent soft tissue injuries of the knee. A torn anterior cruciate ligament leaves the knee joint unstable and at risk for further damage to other soft tissues manifested as pain, dislocation, and osteoarthritis. A better understanding of the anatomical details of knee joints suffering anterior cruciate ligament tears is needed to understand and develop prediction models for anterior cruciate ligament injury and/or tear.
  
  
  METHODS
  Magnetic resonance images of 32 patients with anterior cruciate ligament tears and 40 patients with non-tears were evaluated from a physician group practice. Digital measurements of femoral condyle length, femoral notch width, anterior cruciate ligament width in the frontal and sagittal plane, and the anterior cruciate ligament length in the sagittal plane were taken in both groups to identify trends. Monte Carlo simulations were performed (n = 2000) to evaluate the relationship between notch width index and sagittal width and to establish functional relationships among the anatomical parameters for potential injury risk. Sensitivity analysis performed shows the risk of anterior cruciate ligament injury a function of force and notch width index.
  
  
  RESULTS
  Females have a significantly shorter anterior cruciate ligament when compared to that of males. The notch width index was also significantly different between torn and non-torn individuals. The NWI was not significantly different between genders (p value = 0.40).
  
  
  CONCLUSIONS
  Anterior cruciate ligament injury has been shown to be caused by the forces which act on the ligament. These forces can result from hyperextension of the tibia or the internal rotation of tibia. The anatomical parameters of the knee joint (i.e., notch width index, anterior cruciate ligament width and length) have no role in the cause of an injury.
authors.affiliation: Department of Orthopedic Surgery, Sports Medicine, and Rehabilitation, Wright State University, Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA.
authors.forename: K
authors.initials: K
authors.lastname: Estes
authors.affiliation: Department of Biomedical Engineering, Wright State University, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA. cheruvu.3@wright.edu.
authors.forename: Bharadwaj
authors.initials: B
authors.lastname: Cheruvu
authors.affiliation: Department of Orthopedic Surgery, Sports Medicine, and Rehabilitation, Wright State University, Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA.
authors.forename: M
authors.initials: M
authors.lastname: Lawless
authors.affiliation: Department of Orthopedic Surgery, Sports Medicine, and Rehabilitation, Wright State University, Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA.
authors.forename: R
authors.initials: R
authors.lastname: Laughlin
authors.affiliation: Department of Orthopedic Surgery, Sports Medicine, and Rehabilitation, Wright State University, Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA.|Department of Biomedical Engineering, Wright State University, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA.
authors.forename: T
authors.initials: T
authors.lastname: Goswami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000070598:Anterior Cruciate Ligament Injuries; D002648:Child; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012421:Rupture; D055815:Young Adult
keywords: ACL; BMI; Knee; MRI; NWI; Prediction model