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Three-dimensional intercondylar notch volumes in a skeletally immature pediatric population: a magnetic resonance imaging-based anatomic comparison of knees with torn and intact anterior cruciate ligaments.

Arthroscopy 2013 December
PURPOSE: To determine whether 3-dimensional notch volume, measured with magnetic resonance imaging (MRI), differs significantly between knees with torn and intact anterior cruciate ligaments (ACLs) after sports injury in a skeletally immature pediatric population.

METHODS: MRI studies of 50 pediatric patients (age range, 10 to 17 years) with ACL tears were compared with 50 age- and sex-matched intact-ACL control patients. All patients had open physes and underwent MRI after a sports injury. Notch volume was calculated through manual segmentation of notch boundaries seen on axial 1.5-T proton density-weighted images. Two-dimensional (2D) measurements (notch width and notch width index) were made on coronal proton density-weighted MRI studies. Notch volume was compared between groups by use of the Mann-Whitney U test. Pearson correlation coefficients were also calculated between indices.

RESULTS: Notch volume was significantly lower in knees with ACL tears than in control knees (5.5 ± 1.1 cm(3)v 6.4 ± 1.5 cm(3), P = .002), whereas 2D notch width and notch width index did not differ significantly between these groups. Girls had significantly smaller notch volumes than boys (5.4 ± 1.2 cm(3)v 6.5 ± 1.3 cm(3), P < .001). Notch volume was not correlated with age but was moderately correlated with 2D notch width (r = 0.485, P < .001).

CONCLUSIONS: In adolescent patients with sports injuries, the 3-dimensional notch volume was significantly smaller in knees with ACL tears than in intact-ACL control knees. Notch volume was also significantly smaller in girls than in boys and did not vary significantly with age.

LEVEL OF EVIDENCE: Level III, case-control study.

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