Summary

Investigate the relationship between the three-dimensional volumes of the medial and lateral femoral condyles and meniscus injury in a large cohort of ACL-injured patients.

Abstract

Purpose

Meniscus injuries are one of the most common orthopedic problems worldwide. There is a close connection between the meniscus and the anterior cruciate ligament (ACL). In the presence of knees with an ACL deficiency, it is evident the role of the medial meniscus as a secondary stabilizer. ACL deficiency results in abnormal anterior tibial translation, which increases the risk of meniscal injury. Morphology of the knee were widely studied in patients with ACL injuries. Several studies have demonstrated that the relative parameters can be used to predict the risk of ACL injuries. In contrast, only few studies have examined the anatomical risk factors for meniscus injuries. However, they considered only 2D parameters, which are limited. Indeed, it could happen that the anatomical district of interest is not entirely visible in a single image, due to the principles of imaging acquisition. 3D computer models could provide consistent references for direct evaluation which are not affected by the location of cross section or flexion angle.
The purpose of this study is to investigate the relationship between the three-dimensional volumes of the medial and lateral femoral condyles and meniscus injury. The novelty of this study lies in the use of 3D modeling techniques to evaluate meniscal lesions in a large cohort of patients with ACL rupture.

Method

A total of 93 Magnetic Resonance images of the knees in patients with ACL injuries were examined: 27 patients had lateral meniscal lesion, 21 patients medial meniscal injury, 17 patients both medial and lateral meniscal tears, while the remaining 28 patients had no concomitant meniscal injuries. 3D models of the femur were reconstructed using segmentation process for all the patients. 3D modeling techniques were employed to define and measure the medial and lateral femoral condyle volumes. The portion of the model of interest was delimited using reference planes. The planes were positioned following the reference points indicated by the method of Voss et al. The volume of the selected region was then automatically calculated by the employed 3D modeling software. The independent sample t-test was used to compare the volumes of patients with and without meniscal lesions. The p-value was set at 0.05.

Results

The main finding of the present study is that there is a difference in femoral condyle volumes between patients with and without meniscal tears. In patients with meniscal lesions, the volumes of the lateral (p-value = 0.006) and medial (p-value < 0.001) femoral condyles were statistically significantly different from those of patients without meniscal lesions. Patients with meniscal injuries have higher femoral condyle volumes compared to the patients without concomitant meniscal lesions.

Conclusions

This is the first research that use 3D modeling techniques to evaluate the effect of the condylar volumes on meniscal injuries in patients with ACL injury. Anatomic characteristics of the femur may influence the risk of suffering meniscal injury. This study suggests that femoral condyle volumes may be associated with the injury of the meniscus.