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Correlation between notch width index assessed via magnetic resonance imaging and risk of anterior cruciate ligament injury: an updated meta-analysis

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Abstract

Purpose

To analyze the correlation between notch width index (NWI) and/or femoral intercondylar notch width (NW) assessed by magnetic resonance imaging (MRI) and risk of anterior cruciate ligament (ACL) injury.

Methods

We searched the PubMed, Embase, China National Knowledge Infrastructure and Wanfang databases for literature reporting a correlation between ACL injury and NWI and/or NW. Subgroup analyses were stratified by ethnicity, sex and control source. The weighted mean difference (WMD) and 95% confidence intervals (95% CIs) were calculated for the ACL injury cases and controls using random- or fixed-effects models. Begg’s test and sensitivity analyses were applied to assess publication bias and stability of the results, respectively.

Results

Twenty-eight eligible studies were finally enrolled. The NW was significantly narrowerin the ACL injury cases than in the control cases (pooled WMD, − 1.88 [95% CI, − 2.43 to − 1.32]). The results were similar when stratified by ethnicity and sex. Similarly, the NWI was lower in ACL injury cases than in the controls. Asian populations presented similar results when stratified by ethnicity, among the self-control group when stratified by control source, and among men when stratified by sex. No publication bias was identified; however, the sensitivity analysis suggested unstable results in the NWI subgroup analysis.

Conclusions

The current meta-analysis evidenced that the NW assessed via MRI was significantly smaller in ACL injury cases than in the controls. The NWI was lower in ACL injury cases among men. Prevention strategies for ACL injury could be applied for people with intercondylar notch stenosis.

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Data availability

Data and material are available in this submission.

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Authors and Affiliations

  1. Department of Orthopedics and Arthrology, Shenzhen Pingle Orthopedic Hospital, Pingshan Traditional Chinese Medicine Hospital, No. 40 Jintang Street, Hongling South Road, Luohu District, Shenzhen, 518021, China

    Zheng Li, Changshu Li, Li Li & Ping Wang

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  1. Zheng Li
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  2. Changshu Li
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  3. Li Li
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Contributions

All authors contributed to the study conception and design. ZL, CL, LL, and PW prepared the material and collected and analyzed the data. ZL wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zheng Li.

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Li, Z., Li, C., Li, L. et al. Correlation between notch width index assessed via magnetic resonance imaging and risk of anterior cruciate ligament injury: an updated meta-analysis. Surg Radiol Anat 42, 1209–1217 (2020). https://doi.org/10.1007/s00276-020-02496-6

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