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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2022

10.03.2021 | KNEE

The radiographic tibial spine area is correlated with the occurrence of ACL injury

verfasst von: Takanori Iriuchishima, Bunsei Goto, Freddie H. Fu

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2022

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Abstract

Purpose

The purpose of this study was to reveal the possible influence of the tibial spine area on the occurrence of ACL injury.

Methods

Thirty-nine subjects undergoing anatomical ACL reconstruction (30 female, 9 male: average age 29 ± 15.2) and 37 subjects with intact ACL (21 female, 16 male: average age 29 ± 12.5) were included in this study. In the anterior–posterior (A–P) and lateral knee radiograph, the tibial spine area was measured using a PACS system. In axial knee MRI exhibiting the longest femoral epicondylar length, the intercondylar notch area was measured. Tibial spine area, tibial spine area/body height, and tibial spine area/notch area were compared between the ACL tear and intact groups.

Results

The A–P tibial spine area of the ACL tear and intact groups was 178 ± 34 and 220.7 ± 58mm2, respectively. The lateral tibial spine area of the ACL tear and intact groups was 145.7 ± 36.9 and 178.9 ± 41.7mm2, respectively. The tibial spine area was significantly larger in the ACL intact group when compared with the ACL tear group (A–P: p = 0.02, lateral: p = 0.03). This trend was unchanged even when the tibial spine area was normalized by body height (A–P: p = 0.01, lateral: p = 0.02). The tibial spine area/notch area of the ACL tear and intact groups showed no significant difference.

Conclusion

The A–P and lateral tibial spine area was significantly smaller in the ACL tear group when compared with the ACL intact group. Although the sample size was limited, a small tibial spine might be a cause of knee instability, which may result in ACL injury.

Level of evidence

Level III.
Literatur
1.
Zurück zum Zitat Asai S, Kim D, Hoshino Y, Moon CW, Maeyama A, Linde M, Smolinski P, Fu FH (2018) Coronal tibial anteromedial tunnel location has minimal effect on knee biomechanics. Knee Surg Sports Traumatol Arthrosc 26(10):2960–2965CrossRef Asai S, Kim D, Hoshino Y, Moon CW, Maeyama A, Linde M, Smolinski P, Fu FH (2018) Coronal tibial anteromedial tunnel location has minimal effect on knee biomechanics. Knee Surg Sports Traumatol Arthrosc 26(10):2960–2965CrossRef
2.
Zurück zum Zitat Cavaignac E, Perroncel G, Thépaut M, Vial J, Accadbled F, De Gauzy JS (2017) Relationship between tibial spine size and the occurrence of osteochondritis dissecans: an argument in favour of the impingement theory. Knee Surg Sports Traumatol Arthrosc 25:2442–2446CrossRef Cavaignac E, Perroncel G, Thépaut M, Vial J, Accadbled F, De Gauzy JS (2017) Relationship between tibial spine size and the occurrence of osteochondritis dissecans: an argument in favour of the impingement theory. Knee Surg Sports Traumatol Arthrosc 25:2442–2446CrossRef
3.
Zurück zum Zitat Darcy SP, Kilger RH, Woo SL, Debski RF (2006) Estimation of ACL forces by reproducing knee kinematics between sets of knees: a novel noninvasive methodology. J Biomech 39(13):2371–2377CrossRef Darcy SP, Kilger RH, Woo SL, Debski RF (2006) Estimation of ACL forces by reproducing knee kinematics between sets of knees: a novel noninvasive methodology. J Biomech 39(13):2371–2377CrossRef
4.
Zurück zum Zitat Driscoll MD, Isabell GP Jr, Conditt MA, Ismaily SK, Jupiter DC, Noble PC, Lowe WR (2012) Comparison of 2 femoral tunnel locations in anatomic single-bundle anterior cruciate ligament reconstruction: a biomechanical study. Arthroscopy 28(10):1481–1489CrossRef Driscoll MD, Isabell GP Jr, Conditt MA, Ismaily SK, Jupiter DC, Noble PC, Lowe WR (2012) Comparison of 2 femoral tunnel locations in anatomic single-bundle anterior cruciate ligament reconstruction: a biomechanical study. Arthroscopy 28(10):1481–1489CrossRef
5.
Zurück zum Zitat Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23(11):1218–1225CrossRef Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23(11):1218–1225CrossRef
6.
Zurück zum Zitat Fu FH (2020) Pearls: individualized approach to ACL reconstruction-one size does not fit all. Clin Orthop Relat Res 478(8):1735–1737CrossRef Fu FH (2020) Pearls: individualized approach to ACL reconstruction-one size does not fit all. Clin Orthop Relat Res 478(8):1735–1737CrossRef
7.
Zurück zum Zitat Harner CD, Baek GH, Vogrin TM et al (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15(7):741–749CrossRef Harner CD, Baek GH, Vogrin TM et al (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15(7):741–749CrossRef
8.
Zurück zum Zitat Iriuchishima T, Ryu K, Aizawa S, Fu FH (2015) Size correlation between the tibial anterior cruciate ligament footprint and the tibia plateau. Knee Surg Sports Traumatol Arthrosc 23(4):1147–1152CrossRef Iriuchishima T, Ryu K, Aizawa S, Fu FH (2015) Size correlation between the tibial anterior cruciate ligament footprint and the tibia plateau. Knee Surg Sports Traumatol Arthrosc 23(4):1147–1152CrossRef
9.
Zurück zum Zitat Iriuchishima T, Ryu K, Aizawa S, Fu FH (2016) The difference in centre position in the ACL femoral footprint inclusive and exclusive of the fan-like extension fibres. Knee Surg Sports Traumatol Arthrosc 24(1):254–259CrossRef Iriuchishima T, Ryu K, Aizawa S, Fu FH (2016) The difference in centre position in the ACL femoral footprint inclusive and exclusive of the fan-like extension fibres. Knee Surg Sports Traumatol Arthrosc 24(1):254–259CrossRef
10.
Zurück zum Zitat Iriuchishima T, Suruga M, Yahagi Y, Iwama G, Aizawa S, Fu FH (2020) The location of the femoral ACL footprint center is different depending on the Blumensaat’s line morphology. Knee Surg Sports Traumatol Arthrosc 28(8):2453–2457CrossRef Iriuchishima T, Suruga M, Yahagi Y, Iwama G, Aizawa S, Fu FH (2020) The location of the femoral ACL footprint center is different depending on the Blumensaat’s line morphology. Knee Surg Sports Traumatol Arthrosc 28(8):2453–2457CrossRef
11.
Zurück zum Zitat Iriuchishima T, Goto B, Fu FH (2020) The occurrence of ACL injury influenced by the variance in width between the tibial spine and the femoral intercondylar notch. Knee Surg Sports Traumatol Arthrosc 28(11):3625–3630CrossRef Iriuchishima T, Goto B, Fu FH (2020) The occurrence of ACL injury influenced by the variance in width between the tibial spine and the femoral intercondylar notch. Knee Surg Sports Traumatol Arthrosc 28(11):3625–3630CrossRef
12.
Zurück zum Zitat Iriuchishima T, Ryu K, Aizawa S, Fu FH (2015) Proportional evaluation of anterior cruciate ligament footprint size and knee bony morphology. Knee Surg Sports Traumatol Arthrosc 23(11):3157–3162CrossRef Iriuchishima T, Ryu K, Aizawa S, Fu FH (2015) Proportional evaluation of anterior cruciate ligament footprint size and knee bony morphology. Knee Surg Sports Traumatol Arthrosc 23(11):3157–3162CrossRef
13.
Zurück zum Zitat Karlsson J, Irrgang JJ, van Eck CF, Samuelsson K, Mejia HA, Fu FH (2011) Anatomic single- and double-bundle anterior cruciate ligament reconstruction. Part 2: clinical application of surgical technique. Am J Sports Med 39(9):2016–2026CrossRef Karlsson J, Irrgang JJ, van Eck CF, Samuelsson K, Mejia HA, Fu FH (2011) Anatomic single- and double-bundle anterior cruciate ligament reconstruction. Part 2: clinical application of surgical technique. Am J Sports Med 39(9):2016–2026CrossRef
14.
Zurück zum Zitat Kato Y, Maeyama A, Lertwanich P, Wang JH, Ingham SJ, Kramer S, Martins CQ, Smolinski P, Fu FH (2013) Biomechanical comparison of different graft positions for single-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21(4):816–823CrossRef Kato Y, Maeyama A, Lertwanich P, Wang JH, Ingham SJ, Kramer S, Martins CQ, Smolinski P, Fu FH (2013) Biomechanical comparison of different graft positions for single-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21(4):816–823CrossRef
15.
Zurück zum Zitat Kawaguchi Y, Kondo E, Takeda R, Akita K, Yasuda K, Amis AA (2015) The role of fibers in the femoral attachment of the anterior cruciate ligament in resisting tibial displacement. Arthroscopy 31(3):435–444CrossRef Kawaguchi Y, Kondo E, Takeda R, Akita K, Yasuda K, Amis AA (2015) The role of fibers in the femoral attachment of the anterior cruciate ligament in resisting tibial displacement. Arthroscopy 31(3):435–444CrossRef
16.
Zurück zum Zitat Kondo E, Yasuda K, Azuma H, Tanabe Y, Yagi T (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36(9):1675–1687CrossRef Kondo E, Yasuda K, Azuma H, Tanabe Y, Yagi T (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36(9):1675–1687CrossRef
17.
Zurück zum Zitat Kopf S, Musahl V, Tashman S, Szczodry M, Shen W, Fu FH (2009) A systematic review of the femoral origin and tibial insertion morphology of the ACL. Knee Surg Sports Traumatol Arthrosc 17(3):213–219CrossRef Kopf S, Musahl V, Tashman S, Szczodry M, Shen W, Fu FH (2009) A systematic review of the femoral origin and tibial insertion morphology of the ACL. Knee Surg Sports Traumatol Arthrosc 17(3):213–219CrossRef
18.
Zurück zum Zitat Lansdown D, Ma CB (2018) The influence of tibial and femoral bone morphology on knee kinematics in the anterior cruciate ligament injured knee. Clin Sports Med 37(1):127–136CrossRef Lansdown D, Ma CB (2018) The influence of tibial and femoral bone morphology on knee kinematics in the anterior cruciate ligament injured knee. Clin Sports Med 37(1):127–136CrossRef
19.
Zurück zum Zitat Lee KW, Hwang YS, Chi YJ, Yang DS, Kim HY, Choy WS (2014) Anatomic single bundle anterior cruciate ligament reconstruction by low accessory anteromedial portal technique: an in vivo 3D CT study. Knee Surg Relat Res 26(2):97–105CrossRef Lee KW, Hwang YS, Chi YJ, Yang DS, Kim HY, Choy WS (2014) Anatomic single bundle anterior cruciate ligament reconstruction by low accessory anteromedial portal technique: an in vivo 3D CT study. Knee Surg Relat Res 26(2):97–105CrossRef
20.
Zurück zum Zitat Levins JG, Sturnick DR, Argentieri EC, Gardner-Morse M, Vacek PM, Desarno MJ, Tourville TW, Slauterbeck JR, Beynnon BD (2016) Geometric risk factors associated with noncontact anterior cruciate ligament graft rupture. Am J Sports Med 44(10):2537–2545CrossRef Levins JG, Sturnick DR, Argentieri EC, Gardner-Morse M, Vacek PM, Desarno MJ, Tourville TW, Slauterbeck JR, Beynnon BD (2016) Geometric risk factors associated with noncontact anterior cruciate ligament graft rupture. Am J Sports Med 44(10):2537–2545CrossRef
21.
Zurück zum Zitat Maeyama A, Hoshino Y, Kato Y, Debandi A, Lertwanich P, Wang JH, Smolinski P, Fu FH (2018) Anatomic double bundle ACL reconstruction outperforms any types of single bundle ACL reconstructions in controlling dynamic rotational laxity. Knee Surg Sports Traumatol Arthrosc 26(5):1414–1419CrossRef Maeyama A, Hoshino Y, Kato Y, Debandi A, Lertwanich P, Wang JH, Smolinski P, Fu FH (2018) Anatomic double bundle ACL reconstruction outperforms any types of single bundle ACL reconstructions in controlling dynamic rotational laxity. Knee Surg Sports Traumatol Arthrosc 26(5):1414–1419CrossRef
22.
Zurück zum Zitat Nagai K, Tashiro Y, Herbst E, Gale T, Wang JH, Irrgang JJ, Anderst W, Fu FH (2018) Steeper posterior tibial slope correlates with greater tibial tunnel widening after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 26(12):3717–3723CrossRef Nagai K, Tashiro Y, Herbst E, Gale T, Wang JH, Irrgang JJ, Anderst W, Fu FH (2018) Steeper posterior tibial slope correlates with greater tibial tunnel widening after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 26(12):3717–3723CrossRef
23.
Zurück zum Zitat Oka S, Schuhmacher P, Brehmer A, Traut U, Kirsch J, Siebold R (2016) Histological analysis of the tibial anterior cruciate ligament insertion. Knee Surg Sports Traumatol Arthrosc 24(3):747–753CrossRef Oka S, Schuhmacher P, Brehmer A, Traut U, Kirsch J, Siebold R (2016) Histological analysis of the tibial anterior cruciate ligament insertion. Knee Surg Sports Traumatol Arthrosc 24(3):747–753CrossRef
24.
Zurück zum Zitat Robin BN, Jani SS, Marvil SC, Reid JB, Schillhammer CK, Lubowitz JH (2015) Advantages and disadvantages of transtibial, anteromedial portal, and outside-in femoral tunnel drilling in single-bundle anterior cruciate ligament reconstruction: a systematic review. Arthroscopy 31(7):1412–1417CrossRef Robin BN, Jani SS, Marvil SC, Reid JB, Schillhammer CK, Lubowitz JH (2015) Advantages and disadvantages of transtibial, anteromedial portal, and outside-in femoral tunnel drilling in single-bundle anterior cruciate ligament reconstruction: a systematic review. Arthroscopy 31(7):1412–1417CrossRef
25.
Zurück zum Zitat Siebold R, Ellert T, Metz S, Metz J (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24(2):154–161CrossRef Siebold R, Ellert T, Metz S, Metz J (2008) Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement. Arthroscopy 24(2):154–161CrossRef
26.
Zurück zum Zitat Sturnick DR, Argentieri EC, Vacek PM, DeSarno MJ, Gardner-Morse MG, Tourville TW, Slauterbeck JR, Johnson RJ, Shultz SJ, Beynnon BD (2014) A decreased volume of the medial tibial spine is associated with an increased risk of suffering an anterior cruciate ligament injury for males but not females. J Orthop Res 32(11):1451–1457CrossRef Sturnick DR, Argentieri EC, Vacek PM, DeSarno MJ, Gardner-Morse MG, Tourville TW, Slauterbeck JR, Johnson RJ, Shultz SJ, Beynnon BD (2014) A decreased volume of the medial tibial spine is associated with an increased risk of suffering an anterior cruciate ligament injury for males but not females. J Orthop Res 32(11):1451–1457CrossRef
27.
Zurück zum Zitat Tensho K, Shimodaira H, Aoki T, Narita N, Kato H, Kakegawa A, Fukushima N, Moriizumi T, Fujii M, Fujinaga Y, Saito N (2014) Bony landmarks of the anterior cruciate ligament tibial footprint: a detailed analysis comparing 3-dimensional computed tomography images to visual and histological evaluations. Am J Sports Med 42(6):1433–1440CrossRef Tensho K, Shimodaira H, Aoki T, Narita N, Kato H, Kakegawa A, Fukushima N, Moriizumi T, Fujii M, Fujinaga Y, Saito N (2014) Bony landmarks of the anterior cruciate ligament tibial footprint: a detailed analysis comparing 3-dimensional computed tomography images to visual and histological evaluations. Am J Sports Med 42(6):1433–1440CrossRef
28.
Zurück zum Zitat Vaswani R, Meredith SJ, Lian J, Li R, Nickoli M, Fu FH, Musahl V (2019) Intercondylar notch size can be predicted on preoperative magnetic resonance imaging. Arthrosc Sports Med Rehabil 2(1):e17–e22CrossRef Vaswani R, Meredith SJ, Lian J, Li R, Nickoli M, Fu FH, Musahl V (2019) Intercondylar notch size can be predicted on preoperative magnetic resonance imaging. Arthrosc Sports Med Rehabil 2(1):e17–e22CrossRef
29.
Zurück zum Zitat Wolf MR, Murawski CD, van Diek FM, van Eck CF, Huang Y, Fu FH (2015) Intercondylar notch dimensions and graft failure after single- and double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 23(3):680–686CrossRef Wolf MR, Murawski CD, van Diek FM, van Eck CF, Huang Y, Fu FH (2015) Intercondylar notch dimensions and graft failure after single- and double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 23(3):680–686CrossRef
30.
Zurück zum Zitat Wu E, Chen M, Cooperman D, Victoroff B, Goodfellow D, Farrow LD (2011) No correlation of height or gender with anterior cruciate ligament footprint size. J Knee Surg 24:39–43CrossRef Wu E, Chen M, Cooperman D, Victoroff B, Goodfellow D, Farrow LD (2011) No correlation of height or gender with anterior cruciate ligament footprint size. J Knee Surg 24:39–43CrossRef
31.
Zurück zum Zitat Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30(5):660–666CrossRef Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30(5):660–666CrossRef
32.
Zurück zum Zitat Yahagi Y, Iriuchishima T, Horaguchi T, Suruga M, Tokuhashi Y, Aizawa S (2017) The importance of Blumensaat’s line morphology for accurate femoral ACL footprint evaluation using the quadrant method. Knee Surg Sports Traumatol Arthrosc 26(2):455–461CrossRef Yahagi Y, Iriuchishima T, Horaguchi T, Suruga M, Tokuhashi Y, Aizawa S (2017) The importance of Blumensaat’s line morphology for accurate femoral ACL footprint evaluation using the quadrant method. Knee Surg Sports Traumatol Arthrosc 26(2):455–461CrossRef
33.
Zurück zum Zitat Yasuda K, van Eck CF, Hoshino Y, Fu FH, Tashman S (2011) Anatomic single-and double-bundle anterior cruciate ligament reconstruction. Part 1: basic science. Am J Sports Med 39(8):1789–1799CrossRef Yasuda K, van Eck CF, Hoshino Y, Fu FH, Tashman S (2011) Anatomic single-and double-bundle anterior cruciate ligament reconstruction. Part 1: basic science. Am J Sports Med 39(8):1789–1799CrossRef
Metadaten
Titel
The radiographic tibial spine area is correlated with the occurrence of ACL injury
verfasst von
Takanori Iriuchishima
Bunsei Goto
Freddie H. Fu
Publikationsdatum
10.03.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2022
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-021-06523-w

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