Diagnostic Value of Condylar Distance Asymmetry Relative to the Femoral and Tibial Anatomic Axes in Anterior Cruciate Ligament Rupture
Orthopaedic Journal of Sports Medicine, cilt.14, sa.5, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/23259671261442214
- Dergi Adı: Orthopaedic Journal of Sports Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Directory of Open Access Journals, Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: anterior cruciate ligament, knee joint, femur, tibia, rupture
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Anatomical risk factors for anterior cruciate ligament (ACL) injury remain incompletely defined, particularly those reflecting combined tibiofemoral geometry. Purpose: To determine whether the tibial axis–condylar distance difference (T-ACD) and femoral ACD (F-ACD) are independently associated with ACL rupture and to compare their performance with other morphometric indices. Study Design: Cross-sectional study; Level of evidence, 3. Methods: In this single-center study, 63 magnetic resonance imaging (MRI)–confirmed ACL-ruptured knees were age- and sex-matched to 62 control knees from 2022 to 2024. Weightbearing anteroposterior radiographs provided T-ACD and F-ACD; true lateral radiographs and MRI yielded posterior tibial slope (PTS), lateral tibial height (LTH), medial tibial plateau depth (MTD), lateral femoral condylar index (LFCI), LFC height-to-depth ratio (LFC-H/D) and notch width index (NWI). Two blinded observers performed all measurements and repeated them after 3 weeks; intra- and interobserver reliability were calculated. Multivariate logistic regression with intraclass correlation coefficient (ICC) and receiver operating characteristic analysis assessed independent associations and discriminative ability. Results: ACL rupture knees were younger than controls (27.3 ± 7.9 vs 30.3 ± 7.6 years; P = .04); sex, side, and body mass index were comparable (P > .05). Intraobserver ICC was 0.86 to 0.94 and interobserver ICC measured 0.83 to 0.92. T-ACD, F-ACD, LTH, and LFCI were significantly greater in ruptured knees (P < .001; Cohen d≥ 0.67). A T-ACD ≥4.5 mm conferred an odds ratio of 1.84/mm (95% CI, 1.34-2.53) and showed good discrimination (area under the curve [AUC] = 0.858). The composite model (T-ACD + LTH + LFCI) achieved excellent accuracy (optimism-corrected AUC = 0.957; Nagelkerke R2 = 0.83). PTS, LFC-H/D, MTD, and NWI were not significant predictors (P > .05). Conclusion: Our study showed that coronal-plane condylar height asymmetry, particularly T-ACD, along with LTH and LFCI, may serve as potentially useful morphometric markers for ACL rupture risk. If confirmed by external validation, identification of high-risk morphometry on routine radiographs and MRI may help guide targeted neuromuscular training and injury prevention programs in at-risk individuals