The Effect of Bony Morphology on Anterior Cruciate Ligament Injury and Surgery

Overview

Journal Acta Orthop Traumatol Turc

Specialties Emergency Medicine
Orthopedics

Date 2024 Aug 8

PMID 39115810

Authors

Janina Kaarre

Gillian Ahrendt

Joseph D Giusto

Emre Anil Ozbek

Nicholas A Apseloff

Volker Musah

Affiliations

Soon will be listed here.

Abstract

The exploration of underlying biological risk factors for anterior cruciate ligament (ACL) injury has generated a substantial body of literature describing the role of bony morphology of the knee. Morphological risk factors, such as poor tibiofemoral joint congruity, a narrow femoral intercondylar notch, and an increased posterior tibial slope (PTS), have been implicated in contributing to knee instability and biomechanical abnormalities. Additionally, investigations into sex-specific differences in bony morphology have unveiled distinct risk profiles for males and females. In light of these findings, surgical considerations for individuals with high-risk bony morphology have been developed. Procedures like anterior closing wedge high tibial osteotomy, aiming to address increased PTS, and lateral extra-articular tenodesis for patients with specific risk factors, have been established. The aim of this review is to provide an overview of the current evidence describing the relationship between bony morphology and ACL injury. Moreover, this review aims to discuss the surgical management and outcomes concerning patients exhibiting high-risk anatomic features.

References

Wang Y, Yang T, Zeng C, Wei J, Xie D, Yang Y . Association Between Tibial Plateau Slopes and Anterior Cruciate Ligament Injury: A Meta-analysis. Arthroscopy. 2017; 33(6):1248-1259.e4. DOI: 10.1016/j.arthro.2017.01.015. View

Dan M, Cance N, Pineda T, Demey G, Dejour D . Four to 6° Is the Target Posterior Tibial Slope After Tibial Deflection Osteotomy According to the Knee Static Anterior Tibial Translation. Arthroscopy. 2023; 40(3):846-854. DOI: 10.1016/j.arthro.2023.07.007. View

Bayer S, Meredith S, Wilson K, de Sa D, Pauyo T, Byrne K . Knee Morphological Risk Factors for Anterior Cruciate Ligament Injury: A Systematic Review. J Bone Joint Surg Am. 2020; 102(8):703-718. DOI: 10.2106/JBJS.19.00535. View

Firth A, Bryant D, Litchfield R, McCormack R, Heard M, MacDonald P . Predictors of Graft Failure in Young Active Patients Undergoing Hamstring Autograft Anterior Cruciate Ligament Reconstruction With or Without a Lateral Extra-articular Tenodesis: The Stability Experience. Am J Sports Med. 2022; 50(2):384-395. PMC: 8829733. DOI: 10.1177/03635465211061150. View

Feucht M, Mauro C, Brucker P, Imhoff A, Hinterwimmer S . The role of the tibial slope in sustaining and treating anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc. 2012; 21(1):134-45. DOI: 10.1007/s00167-012-1941-6. View

Chiba D, Gale T, Nishida K, Suntaxi F, Lesniak B, Fu F . Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. Am J Sports Med. 2021; 49(7):1803-1812. DOI: 10.1177/03635465211003298. View

Micicoi G, Jacquet C, Khakha R, LiArno S, Faizan A, Seil R . Femoral and Tibial Bony Risk Factors for Anterior Cruciate Ligament Injuries Are Present in More Than 50% of Healthy Individuals. Am J Sports Med. 2021; 49(14):3816-3824. DOI: 10.1177/03635465211050421. View

van Diek F, Wolf M, Murawski C, Van Eck C, Fu F . Knee morphology and risk factors for developing an anterior cruciate ligament rupture: an MRI comparison between ACL-ruptured and non-injured knees. Knee Surg Sports Traumatol Arthrosc. 2013; 22(5):987-94. DOI: 10.1007/s00167-013-2588-7. View

Wilson W, Hopper G, OBoyle M, Henderson L, Blyth M . Quantifying graft impingement in anterior cruciate ligament reconstruction. Knee. 2022; 34:270-278. DOI: 10.1016/j.knee.2022.01.001. View

10.

Bojicic K, Beaulieu M, Imaizumi Krieger D, Ashton-Miller J, Wojtys E . Association Between Lateral Posterior Tibial Slope, Body Mass Index, and ACL Injury Risk. Orthop J Sports Med. 2017; 5(2):2325967116688664. PMC: 5315236. DOI: 10.1177/2325967116688664. View

11.

Fahim S, Dhawan T, Jagadeesh N, Ashwathnarayan Y . The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width, notch width index, notch shape - A randomized control study. J Clin Orthop Trauma. 2021; 17:5-10. PMC: 7920122. DOI: 10.1016/j.jcot.2021.01.006. View

12.

Gibbs C, Hughes J, Popchak A, Chiba D, Lesniak B, Anderst W . Anterior cruciate ligament reconstruction with lateral extraarticular tenodesis better restores native knee kinematics in combined ACL and meniscal injury. Knee Surg Sports Traumatol Arthrosc. 2021; 30(1):131-138. DOI: 10.1007/s00167-021-06476-0. View

13.

Shi W, Gao Y, Zhang K, Liu P, Yang Y, Ma Y . Femoral Tunnel Malposition, Increased Lateral Tibial Slope, and Decreased Notch Width Index Are Risk Factors for Non-Traumatic Anterior Cruciate Ligament Reconstruction Failure. Arthroscopy. 2023; 40(2):424-434.e3. DOI: 10.1016/j.arthro.2023.06.049. View

14.

Bernhardson A, Aman Z, Dornan G, Kemler B, Storaci H, Brady A . Tibial Slope and Its Effect on Force in Anterior Cruciate Ligament Grafts: Anterior Cruciate Ligament Force Increases Linearly as Posterior Tibial Slope Increases. Am J Sports Med. 2019; 47(2):296-302. DOI: 10.1177/0363546518820302. View

15.

Bongbong D, Oeding J, Ma C, Pedoia V, Lansdown D . Posterior Tibial Slope, Notch Width, Condylar Morphology, Trochlear Inclination, and Tibiofemoral Mismatch Predict Outcomes Following Anterior Cruciate Ligament Reconstruction. Arthroscopy. 2021; 38(5):1689-1704.e1. DOI: 10.1016/j.arthro.2021.11.055. View

16.

Mabrouk A, Kley K, Jacquet C, Fayard J, An J, Ollivier M . Outcomes of Slope-Reducing Proximal Tibial Osteotomy Combined With a Third Anterior Cruciate Ligament Reconstruction Procedure With a Focus on Return to Impact Sports. Am J Sports Med. 2023; 51(13):3454-3463. DOI: 10.1177/03635465231203016. View

17.

Dadoo S, Ozbek E, Nukuto K, Runer A, Keeling L, Grandberg C . What it takes to have a high-grade pivot shift-focus on bony morphology. Knee Surg Sports Traumatol Arthrosc. 2023; 31(10):4080-4089. DOI: 10.1007/s00167-023-07472-2. View

18.

Pfeiffer T, Burnham J, Kanakamedala A, Hughes J, Zlotnicki J, Popchak A . Distal femur morphology affects rotatory knee instability in patients with anterior cruciate ligament ruptures. Knee Surg Sports Traumatol Arthrosc. 2018; 27(5):1514-1519. DOI: 10.1007/s00167-018-5269-8. View

19.

Hodel S, Kabelitz M, Tondelli T, Vlachopoulos L, Sutter R, Fucentese S . Introducing the Lateral Femoral Condyle Index as a Risk Factor for Anterior Cruciate Ligament Injury. Am J Sports Med. 2019; 47(10):2420-2426. DOI: 10.1177/0363546519858612. View

20.

Elmansori A, Lording T, Dumas R, Elmajri K, Neyret P, Lustig S . Proximal tibial bony and meniscal slopes are higher in ACL injured subjects than controls: a comparative MRI study. Knee Surg Sports Traumatol Arthrosc. 2017; 25(5):1598-1605. DOI: 10.1007/s00167-017-4447-4. View