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L. BUISSON, G. ESTOUR, A. PINAROLI
180
THE MEDIPOLE CLINIC
STUDY
Our study is based upon 200 cases of repaired
ACLs (group A) with eleven re-repaired cases
receiving a follow up over 2 years with an
MRI ; and a control group (group B) of
200 cases with intact ACL analysed with an
MRI. The arthroscopic shape and the width
index of the indercondylar notch was analysed
in these two groups.
• Group A
contains 43 females for 157 males
with 56% of right knees and a average age of
36 years old (15 to 56).
• Group B
contains 92 females for 108 males
with 52% of right knees and a average age of
31 years old (20 to 40).
In group A, the ACL tear mainly came from a
Valgus flexion external rotation of the knee
(80% of cases) and from sports like handball
(7%), football (30%), basketball (4%), rugby
(3%), skiing (40%) and snow board (1%) and
other axis sport.
We found 5 types of inter-condylar notch:
large, normal, larger lateral condyle, narrow
and very narrow inter-condylar notch (ICN)
with triangular aspect.
We found 37 cases of narrow and very narrow
ICN (18,5%) with 30/157 (19%) males and
7/43 females (16%). The bilateral cases do not
have specifically narrow ICN (only 15%).
But we found in these cases that most often,
they had an external flexion traumatic injury.
No difference can be found in the comparison
of both groups’ narrow ICN and normal ICN in
the bilateral cases. Those groups have the same
percentage of cases : 14%
versus
11%.
This result does not confirm the Shelbourne
analysis [10] which finds a signifiant différence
in the 714 ICN measured cases analysis in
which 6% of bilateral cases where the ICN is
narrow for only 1% of cases if the ICN is
normal. However, this analysis considers large
ICN over 16 mm which does not have the same
point of view as in other studies showing
22 mm for normal ICN and more than 26 mm
for large ICN. That means that the index has a
more objective criteria than the real value in
millimeters.
In our study we have noted that the possibility
of an ACL tear in full extension (22 cases:
11%) does not concern the narrow notch with
triangular aspect but most frequently a normal
ICN. The tear depends on the extent of the
Fig. 1:
Inter-condylar Notch index.