Comparative analysis of morphometric parameters of intercondylar notch in patients with and without anterior cruciate ligament tears

Nazanin Farshchian, Satar Sohrabi, Mansour Rezaei

DOI: 10.22122/cdj.v1i1.28


BACKGROUND: Anterior cruciate ligament (ACL) injury is the most common type of ligament injury whose prevalence is higher in athletes. There are different external risk factors for this injury. However, it is important to find its physiological risk factors, as well. This study assessed the relationship between morphometric parameters of intercondylar notch and ACL tears in patients suffering from knee complications.

METHODS: Patients with or without ACL tears who had undergone knee magnetic resonance imaging for any reason were recruited based on inclusion criteria. Intercondylar notch width, femoral bicondylar width, and intercondylar notch index were calculated in both groups. Then, significant variables from univariate analysis were entered in multiple regression analysis with intercondylar notch width, femoral bicondylar width, and intercondylar notch index being assumed as dependent variables.

RESULTS: Overall, 199 participants, including 81 patients with ACL tear and 118 without ACL tear, were evaluated. Multiple regression analysis revealed intercondylar notch width and intercondylar notch index to be less common among women and subjects with ACL tears (P < 0.001).

CONCLUSION: Based on the results of this study, there are relationships between ACL tears and being female and intercondylar notch width. Therefore, intercondylar notch index can be used for screening athletes and people at risk of ACL tears.


Anterior Cruciate Ligament Tear, Intercondylar Notch, Femoral Bicondylar Width, Intercondylar Notch Index

Full Text:



Stijak L, Radonjic V, Nikolic V, Blagojevic Z, Aksic M, Filipovic B. Correlation between the morphometric parameters of the anterior cruciate ligament and the intercondylar width: gender and age differences. Knee Surg Sports Traumatol Arthrosc 2009; 17(7): 812-7.

Granan LP, Bahr R, Steindal K, Furnes O, Engebretsen L. Development of a national cruciate ligament surgery registry: the Norwegian National Knee Ligament Registry. Am J Sports Med 2008; 36(2): 308-15.

Lobenhoffer P. Injuries of the knee ligaments. II. Surgical therapy of anterior and posterior knee instability. Chirurg 1999; 70(3): 326-38. [In German].

Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W, et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med 2008; 42(6): 394-412.

Gottlob CA, Baker CL, Jr., Pellissier JM, Colvin L. Cost effectiveness of anterior cruciate ligament reconstruction in young adults. Clin Orthop Relat Res 1999; (367): 272-82.

Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 2007; 35(10): 1756-69.

Hewett TE. Neuromuscular and hormonal factors associated with knee injuries in female athletes. Strategies for intervention. Sports Med 2000; 29(5): 313-27.

Hewett TE, Lynch TR, Myer GD, Ford KR, Gwin RC, Heidt RS, Jr. Multiple risk factors related to familial predisposition to anterior cruciate ligament injury: fraternal twin sisters with anterior cruciate ligament ruptures. Br J Sports Med 2010; 44(12): 848-55.

Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med 1999; 27(6): 699-706.

Hewett TE, Ford KR, Myer GD. Anterior cruciate ligament injuries in female athletes: Part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med 2006; 34(3): 490-8.

LaPrade RF, Burnett QM. Femoral intercondylar notch stenosis and correlation to anterior cruciate ligament injuries. A prospective study. Am J Sports Med 1994; 22(2): 198-202.

Souryal TO, Moore HA, Evans JP. Bilaterality in anterior cruciate ligament injuries: associated intercondylar notch stenosis. Am J Sports Med 1988; 16(5): 449-54.

Lund-Hanssen H, Gannon J, Engebretsen L, Holen KJ, Anda S, Vatten L. Intercondylar notch width and the risk for anterior cruciate ligament rupture. A case-control study in 46 female handball players. Acta Orthop Scand 1994; 65(5): 529-32.

Good L, Odensten M, Gillquist J. Intercondylar notch measurements with special reference to anterior cruciate ligament surgery. Clin Orthop Relat Res 1991; (263): 185-9.

Souryal TO, Freeman TR. Intercondylar notch size and anterior cruciate ligament injuries in athletes. A prospective study. Am J Sports Med 1993; 21(4): 535-9.

Davis TJ, Shelbourne KD, Klootwyk TE. Correlation of the intercondylar notch width of the femur to the width of the anterior and posterior cruciate ligaments. Knee Surg Sports Traumatol Arthrosc 1999; 7(4): 209-14.

Wada M, Tatsuo H, Baba H, Asamoto K, Nojyo Y. Femoral intercondylar notch measurements in osteoarthritic knees. Rheumatology (Oxford) 1999; 38(6): 554-8.

Stijak L, Nikolic V, Blagojevic Z, Radonjic V, Santrac-Stijak G, Stankovic G, et al. Influence of morphometric intercondylar notch parameters in ACL ruptures. Acta Chir Iugosl 2006; 53(4): 79-83. [In Serbian].

Alizadeh A, Kiavash V. Mean intercondylar notch width index in cases with and without anterior cruciate ligament tears. Iran J Radiol 2008; 5(4): 205-8.

Lombardo S, Sethi PM, Starkey C. Intercondylar notch stenosis is not a risk factor for anterior cruciate ligament tears in professional male basketball players: an 11-year prospective study. Am J Sports Med 2005; 33(1): 29-34.

Schickendantz MS, Weiker GG. The predictive value of radiographs in the evaluation of unilateral and bilateral anterior cruciate ligament injuries. Am J Sports Med 1993; 21(1): 110-3.

Teitz CC, Lind BK, Sacks BM. Symmetry of the femoral notch width index. Am J Sports Med 1997; 25(5): 687-90.

Murshed KA, Cicekcibasi AE, Karabacakoglu A, Seker M, Ziylan T. Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging. Surg Radiol Anat 2005; 27(2): 108-12.

Dienst M, Schneider G, Altmeyer K, Voelkering K, Georg T, Kramann B, et al. Correlation of intercondylar notch cross sections to the ACL size: a high resolution MR tomographic in vivo analysis. Arch Orthop Trauma Surg 2007; 127(4): 253-60.

Chandrashekar N, Slauterbeck J, Hashemi J. Sex-based differences in the anthropometric characteristics of the anterior cruciate ligament and its relation to intercondylar notch geometry: a cadaveric study. Am J Sports Med 2005; 33(10): 1492-8.

Staeubli HU, Adam O, Becker W, Burgkart R. Anterior cruciate ligament and intercondylar notch in the coronal oblique plane: anatomy complemented by magnetic resonance imaging in cruciate ligament-intact knees. Arthroscopy 1999; 15(4): 349-59.

Flynn RK, Pedersen CL, Birmingham TB, Kirkley A, Jackowski D, Fowler PJ. The familial predisposition toward tearing the anterior cruciate ligament: a case control study. Am J Sports Med 2005; 33(1): 23-8.

Anderson AF, Lipscomb AB, Liudahl KJ, Addlestone RB. Analysis of the intercondylar notch by computed tomography. Am J Sports Med 1987; 15(6): 547-52.

Maffulli N, Longo UG, Denaro V. Anterior cruciate ligament tear. N Engl J Med 2009; 360(14): 1463.

Mountcastle SB, Posner M, Kragh JF, Jr., Taylor DC. Gender differences in anterior cruciate ligament injury vary with activity: epidemiology of anterior cruciate ligament injuries in a young, athletic population. Am J Sports Med 2007; 35(10): 1635-42.

Adamczyk G. ACL - deficient knee. Acta Clinica 2002; 2(1): 11-6. Available from: URL:

Griffin LY, Albohm MJ, Arendt EA, Bahr R, Beynnon BD, Demaio M, et al. Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005. Am J Sports Med 2006; 34(9): 1512-32.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.