The Diagnosis and Treatment of Femoral Intercondylar Notch Non-Bony Impingement Syndrome: 15 Cases Report / 中国运动医学杂志

Objective To summarize clinical features and explore diagnosis and treatment of femoral intercondylar notch non-bony impingement syndrome. Methods 15 patients of femoral intercondylar notch non-bony impingement syndrome were identified during arthroscopic operation of 115 patients (120 knees) with restricted knee joint extention during Oct 2004 to Dec 2007. Among these 15 patients, there were 3 cases of Bucket Handle Tear(BHT), 1 case of ACL's cyst, 3 cases of ACL tibial avulsion injury, 3 cases of synovial incarceration, and 5 cases of synovial chondroma. 9 patients were diagnosed by MRJ and 2 by X-ray before operation. All 15 patients were confirmed under arthroscopy. Results 15 patients( 15 knees) were operated and followed up for a period of 4～24 months, mean 13 months. Mean Lysholm score was 65(range, 41～75) before operation and 89(range, 75～100) after operation. Joint extension restrict was 5～25 degrees (mean 8.1 degree) before operation and 0 degree after operation. Conclusion Arthroscopy could accurately diagnose femoral Intercondylar notch non-bony impingement syndrome. Pre-operation MRI was helpful for diagnosis. If MRI and X-ray showed negative findings, diagnostic arthroscopic examination could be applied. Good subjective and objective effects could be achieved with arthroscopic operation.

Clinical Relevance of the Femoral Intercondylar Notch Width and the Posterior Tibial Slope for ACL Rupture

PURPOSE: The purpose of this study was to evaluate the relationship between the femoral intercondylar notch width (ICW), the posterior tibial slope angle (PTS), rupture of the anterior cruciate ligament (ACL) and the ruptured site. MATERIALS AND METHODS: We retrospectively reviewed 105 cases of ruptured ACL (105 patients), and 91 cases of intact ACL (91 patients). The ICW and PTS were measured from the plain knee radiographs. The ratio of the ICW and the femoral intercondylar notch height (ICH) was also measured. As for the site of ACL rupture, the patients with a ruptured ACL were divided into 3 groups (group 1: femoral attach site, 2: mid-substance, 3: tibial attach site), and the correlations between the ICW and the PTS of each group were analyzed. RESULTS: The mean ICW of the ACL ruptured group was 15.51+/-4.30 mm (95% confidence interval: 15.48~15.53), that of the ACL intact group was 24.49+/-3.86 mm (24.47~24.52), and the mean PTS of the ruptured ACL group was 7.68+/-3.78degrees (7.65~7.70) and that of the intact ACL group was 6.12+/-3.85degrees (6.10~6.13). A narrow ICW was a significant risk factors for ACL rupture (odds ratio=0.661 [0.602~0.720], p<0.01). But we did not get any statistically significant results for the increase PTS (odds ratio=1.073 [1.062~1.134], p=0.197). According to the ruptured site, the analysis of variance of the ICW and PTS had no significant correlation. CONCLUSION: A narrow ICW is a significant risk factor for ACL rupture.

Differences of Femoral Intercondylar Notch on MRI: Between Normal and Anterior Cruciate Ligamen Injured Knee

PURPOSE: The purpose of this study is to evaluate the possible relationship between femoral intercondylar notch stenosis and ACL injury according to gender with retrospective analysis of knee MRI. MATERIALS AND METHODS: The study was based on 260 cases of knee MRI (except the cases of combined colleteral ligaments injury and fracture) between the ages of 18 and 50 years from March 1995 to March 2001. All cases were divided into three groups : group 1 consisted of knees 94 cases that were nor-mal, group 2 consisted of knees from 72 cases that had a contact ACL injury, group 3 consisted of knees from 92 cases that had a non contact ACL injury. We measured the notch height, notch width at the point of 1/3, 2/3 of notch height, notch angle, lateral angle with coronal section. Each measurements of three groups were compared with gender and for statistical significance using the ANOVA test. RESULTS: The mean notch angle was 48.2 +/-6.7 degrees for men and 47.1 +/-1.2 degrees for women in group 1, 48.7 +/- 6.5 degrees for men and 48.7 +/-1.2 degrees for women in group 2, 47.4 +/-6.5 degrees for men and 47.3 +/-1.5 degrees for women in group 3. The mean notch width at the point of 1/3, 2/3of notch height were 18.6 +/-2.4 mm, 15.3 +/-2.4 mm for men and 16.9 +/-2.4 mm, 14.2 +/-2.4 mm for women in group 1, 18.2 +/-2.4 mm, 15.2 +/-2.4 mm for men and 16.7 +/-2.4 mm, 13.9 +/-2.4 mm for women in group 2, 16.8 +/-2.4 mm, 13.9 +/-2.4 mm for men and 15.7 +/-2.4 mm, 13.4 +/-2.4 mm for women in group 3. Statistically significant differences were found between sexes in group 3 in regard to notch width at the point of 1/3, 2/3 of notch height, notch angle(<0.05). CONCLUSION: Stenosis of femoral intercondylar notch may be a factor of ACL injury. So preoperative measurement of femoral intercondylar notch may be necessary to determine the amount of notchplasty degree in ACL reconstruction.

A radiographic measurement of the width of the intercondylar notch / 中华放射学杂志

0.05). The notch width index was 0.24?0.05. There was no correlation between the notch width index and the height (r=-0.11), the body weight (r=-0.13), and the age (r=-0.28). Conclusion The notch-view radiographs with 45? flexion of the knee can satisfactorily show the shape and the width of the intercondylar notch. The notch width and the notch width index of the normal knee are (18.9?4.8) mm and 0.24?0.05, respectively. The height and the body weight can′t be used to predict the notch width. The study supplies the radiographic basis for the diagnosis and treatment of the diseases related with the femoral intercondylar notch.