Skip to main content

Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation

Skeletal Radiology volume 37, pages 821–826 (2008)Cite this article

Abstract

Objective

The purpose of this study was to evaluate the relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch.

Materials and methods

We retrospectively reviewed the 105 patients with knee magnetic resonance imaging (MRI) with or without knee arthroscopy [group 1: patients with arthroscopic notchplasty (N = 47), group 2: knee arthroscopy demonstrating intact ACL (N = 33), and group 3: patients with normal knee MRI but no arthroscopy (N = 25)]. Groups 2 and 3 served as an arthroscopic and MR control group, respectively. Two musculoskeletal radiologists reviewed all MR examinations. The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area were recorded on axial and sagittal MR images at the midpoint of Blumensaat’s line which was identified on sagittal images. The diameter of the ACL was recorded on coronal MR images at the posterior end of Blumensaat’s line.

Results

The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter for the three groups were 16.0 mm/0.2/50.3°/36.5°/249.0 mm2/7.7 mm (group 1); 19.3 mm/0.3/52.9°/40.2°/323.4 mm2/4.8 mm (group 2); and 20.3 mm/0.3/51.4°/39.1°/350.8 mm2/4.5 mm (group 3). The intercondylar notch width, notch index, SNA, and notch area were smaller, and ACL diameter was thicker in group 1 compared with the other groups (p < 0.05).

Conclusion

Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area than control groups.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Skelet Radiol 2001; 30: 312–315.

    CAS  Article  Google Scholar 

  2. Hernigou P, Garabedian JM. Intercondylar notch width and the risk of anterior cruciate ligament rupture in the osteoarthritic knee: evaluation by plain radiography and CT scan. Knee 2002; 9: 313–316.

    PubMed  Article  Google Scholar 

  3. Goldberg VM, Burstein A, Dawson M. The influence of an experimental immune synovitis on the failure mode and strength of the rabbit anterior cruciate ligament. J Bone Joint Surg Am 1982; 64: 900–906.

    CAS  PubMed  Article  Google Scholar 

  4. Rolf C, Watson TP. Case report: intra-tendinous ganglion of the anterior cruciate ligament in a young footballer. J Orthop Surg 2006; 1: 11.

    PubMed Central  Article  Google Scholar 

  5. Narvekar A, Gajjar S. Mucoid degeneration of the anterior cruciate ligament. Arthroscopy 2004; 2: 141–146.

    Article  Google Scholar 

  6. Nelissen RG, Hogendoorn PC. Retain or sacrifice the posterior cruciate ligament in total knee arthroplasty? A histopathological study of the cruciate ligament in osteoarthritic and rheumatoid disease. J Clin Pathol 2001; 54: 381–384.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  7. Zantop T, Rusch A, Hassenpflug J, Petersen W. Intra-articular ganglion cysts of the cruciate ligaments: case report and review of the literature. Arch Orthop Trauma Surg 2003; 123(4): 195–198.

    PubMed  Article  Google Scholar 

  8. Huang GS, Lee CH, Chan WP, et al. Ganglion cysts of the cruciate ligaments. Acta Radiol 2002; 43 (4): 419–424.

    PubMed  Article  Google Scholar 

  9. Melloni P, Valls R, Yuguero M, Sáez A. Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle. Skelet Radiol 2004; 33(6): 359–362.

    Article  Google Scholar 

  10. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Am J Roentgenol 2004; 182: 1283–1287.

    Article  Google Scholar 

  11. Quasnichka HL, Anderson-MacKenzie JM, Tarlton JF, Sims TJ, Billingham ME, Bailey AJ. Cruciate ligament laxity and femoral intercondylar notch narrowing in early-stage knee osteoarthritis. Arthritis Rheum 2005; 52(10): 3100–3109.

    PubMed  Article  Google Scholar 

  12. Dienst M, Schneider G, Altmeyer K, 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; 124(4): 253–260.

    Article  Google Scholar 

  13. Lee GC, Cushner FD, Vigoritta V, Scuderi GR, Insall JN, Scott WN. Evaluation of the anterior cruciate ligament integrity and degenerative arthritic patterns in patients undergoing total knee arthroplasty. J Arthroplasty 2005; 20(1): 59–65.

    PubMed  Article  Google Scholar 

  14. Ireland ML, Ballantyne BT, Little K, McClay IS. A radiographic analysis of the relationship between the size and shape of the intercondylar notch and anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 2001; 9(4): 200–205.

    CAS  PubMed  Article  Google Scholar 

  15. Comerford EJ, Tarlton JF, Avery NC, Bailey AJ, Innes JF. Distal femoral intercondylar notch dimensions and their relationship to composition and metabolism of the canine anterior cruciate ligament. Osteoarthritis Cartilage 2006; 14(3): 273–278.

    CAS  PubMed  Article  Google Scholar 

  16. Jagodzinski M, Richter GM, Pässler HH. Biomechanical analysis of knee hyperextension and of the impingement of the anterior cruciate ligament: a cinematographic MRI study with impact on tibial tunnel positioning in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2000; 8(1): 11–19.

    CAS  PubMed  Article  Google Scholar 

  17. Fealy S, Kenter K, Dines JS, Warren RF. Mucoid degeneration of the anterior cruciate ligament. Arthroscopy 2001; 17: E37.

    CAS  PubMed  Article  Google Scholar 

  18. Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint: anatomical, functional, and experimental analysis. Clin Orthop 1975; 106: 216–231.

    Article  Google Scholar 

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

    CAS  PubMed  Article  Google Scholar 

  20. Souryal TO, Freeman TR. Intercondylar notch size and anterior cruciate ligament injuries in athletes. A prospective study. Am J Sports Med 1993; 21(4): 535–539.

    CAS  PubMed  Article  Google Scholar 

  21. Fayad LM, Parellada JA, Parker L, Schweitzer ME. MR imaging of anterior cruciate ligament tears: is there a gender gap. Skelet Radiol 2003; 32(11): 639–646.

    Article  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Ji Hyeon Cha, Sang Hoon Lee, Myung Jin Shin & Byeong Kyoo Choi

  2. Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Sung Il Bin

  3. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap2-dong, Songpa-gu, Seoul, 138-736, South Korea

    Sang Hoon Lee

Authors
  1. Ji Hyeon Cha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sang Hoon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Myung Jin Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Byeong Kyoo Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sung Il Bin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sang Hoon Lee.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Cha, J.H., Lee, S.H., Shin, M.J. et al. Relationship between mucoid hypertrophy of the anterior cruciate ligament (ACL) and morphologic change of the intercondylar notch: MRI and arthroscopy correlation. Skeletal Radiol 37, 821–826 (2008). https://doi.org/10.1007/s00256-008-0527-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-008-0527-3

Keywords

  • Mucoid hypertrophy
  • Anterior cruciate ligament
  • MRI
  • Arthroscopy