The relationship of distal femur and proximal tibia morphology with anterior cruciate ligament injuries.

Purpose: The study aims to determine the correlations between the anatomical structures of the distal femur and proximal tibia associated with the anterior cruciate ligament (ACL).

Methods: Bilateral extremities of 293 patients [143 ACL-ruptured, 150 ACL-intact] (all male) were included in the study. Femoral bi-condylar width (BCW), intercondylar notch width (NW) in the distal femur, proximal tibia width (TW), and tibial eminence width (EW) parameters were measured in the proximal tibia. Indexes are calculated as intercondylar notch width index (NWI) = NW/BCW, tibial eminence width index (EWI) = EW/TW.

Results: BCW, NW, TW, and EW measurements were lower in the ACL-ruptured group, but the difference was statistically significant only in the NW (p = 0.009) and TW (p = 0.005) measurements. There was no difference between groups in the NWI. The EWI parameters were calculated higher in the ACL-ruptured group, and the difference was statistically significant (p = 0.02). In both groups, there were very strong correlations between BCW and TW (ACL-ruptured r = 0.820, ACL-intact r = 0.877) and between NW and NWI (ACL-ruptured r = 0.862, ACL-intact r = 0.852), also EW and EWI in ACL-intact group (r = 0.947).

Conclusions: The NW and TW measurements may give an idea about injury risk or prevention in morphological measurements. Correlations also show that the femur and tibia should consider together for ACL injuries.