Triangular notch morphology in young males linked to increased risk of non-contact anterior cruciate ligament tears

Objectives: The knee joint, critical for human mobility, faces a heightened risk of injuries, with non-contact anterior cruciate ligament (ACL) tears occurring at a notable rate. This study aims to investigate the relationship between femoral intercondylar notch (ICN) morphometry, assessed through magnetic resonance imaging (MRI), and non-contact ACL tears. Given the anatomical intricacies of the femoral ICN, understanding its morphometry becomes imperative. The study also considers sex-based differences, the influence of individual height, and various notch shapes, including triangular, “U,” and omega configurations. Materials and Methods: A cross-sectional study involving 100 patients undergoing knee MRI examinations was conducted. Inclusion criteria encompassed patients over 18 years with a history of trauma and clinical evidence of knee joint instability. Measurements of femoral ICN were made using a 3 Tesla MRI scanner, with parameters such as notch depth, width, ICN width index (ICNWI), notch angle, and alpha angle (AA) being evaluated in axial and coronal planes. Results: Among 100 cases of non-contact ACL injuries, MRI examination revealed distinct ICN shapes: 24% triangular, 34% omega-shaped, and 42% U shaped. Triangular notches were more prevalent in young adults, with a mean age of approximately 25 years. Analysis of femoral ICN dimensions showed no significant associations for notch depth, width, ICNWI, notch angle, and AA. However, a significant difference in age was noted for the triangular-shaped ICN. Conclusion: Our study suggests a notable association between a triangular-shaped ICN, young age, and male individuals with a higher prevalence of non-contact ACL tears.