Relationship between Femoral Intercondylar Notch Narrowing in Radiography and Anatomical and Histopathologic Integrity of Anterior Cruciate Ligament in Patients Undergoing Total Knee Replacement Surgery

Document Type : RESEARCH PAPER


1 Orthopedic Department, Arak University of Medical Sciences, Arak, Iran

2 Pathology Department, Arak University of Medical Sciences, Arak, iran

3 bone and joint reconstruction research center, shafa yahian hospital , iran univercity medical science

4 Bone and Joint Reconstruction Research Center, Shafa Yahyaian Hospital, Iran university of Medical Science, Tehran, Iran

5 Valiasr Hospital, Arak University of Medical Sciences, Arak, Iran

6 Radiology Department, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran


Background: The presence of cruciate ligaments is very important for normal knee kinematics. Knee arthroplasty
prostheses, in which these ligaments are maintained, have better kinematics. The aim of the present study was to
investigate the association between femoral intercondylar notch (FIN) narrowing in radiography and clinical and
histopathologic integrity of anterior cruciate ligament (ACL) in patients undergoing knee replacement surgery.
Methods: FIN index was measured in tunnel view radiography of the knees of 102 candidates of knee replacement
surgery. The anatomical status of ACL was also examined during total knee arthroplasty (TKA). ACL was removed and
sent for histopathologic examination to assess its degeneration rate. The association between the FIN index and the
clinical and histopathological health of ACL was investigated.
Results: Among 102 patients with mean age of 69.73 ± 7.81 years , 39 patients (38.32%) had no or torn ACL, 31
patients (30.39%) had weak ACL, and 32 (31.37%) had normal ACL. There was a significant association between age
and clinical status of ACL during surgery (P=0.017). There was a significant difference in FIN and ACL health status
during surgery between the two groups with an index of more and less than 0.252 (P=0.019 and P=0.019, respectively).
There was no significant difference in the mean total degeneration score (TDS) of ACL between the two groups with FIN
more and less than 0.252 (P=0.816).
Conclusion: There was a significant difference between the age and FIN narrowing (less than 0.252) as well as ACL
clinical status during surgery. FIN narrowing had no significant effect on the severity of ACL degeneration and there was
no significant difference in the severity of degenerative histopathologic changes between healthy and attenuated ACLs.
This indicates that if ACL exists, although apparently attenuated, it has the histologic characteristic of a healthy ligament.
Level of evidence: II


Main Subjects

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