I met with Dr Vincent Eggerding, MD, who is a researcher in Sports Medicine, Traumatology and Orthopaedic Surgery for the Dept of Orthopaedics at Erasmus MC. He has published an interesting paper on knee joint shape possibly predicting clinical outcome after ACL ligament rupture. You can read the abstract in Bone and Joint Journal, 96-B(6) : 737-42, June 2014.
Statistical shape modelling was used to measure the shape of the knee joint in 182 patients after ACL rupture. Knee shape was then associated with International Knee Committee Subjective Scores (IKDC) at 2 years follow up. They found that 2 shapes were significantly associated with subjective score at 2 years, one for the operative group and one for the non- operative group.
Operative patients who scored better on the IDKC at 2 years had a smaller intercondylar notch and a smaller width of the intercondylar eminence.
Non-operative patients who scored better on the IDKC at 2 years had a more pyramidal intercondylar notch as opposed to a more dome shaped notch.
The Clinical Translator : The bony shape of the knee is a fixed non-modifiable factor which may influence outcome post ACL injury and subsequent success of either operative or non-operative management. The authors of this study found at least 30 different shape variations of the knee joint reminding us of individual anatomical variability. Knee joint shape may play a role in inherent knee joint stability and influence ACL injury outcomes. The Clinician must remember though it is only one of many important factors when considering ACL injury outcomes.
**This is intended as an aid to the clinician to translate research findings into clinical practice but is my own opinion based on the available current research evidence and my clinical expertise and experience. Clinicians should consider if this advice is appropriate for them and use their own reasoning processes considering the individual patient in question.
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