Tibial spine volume is smaller in ACL-injured athletes compared to healthy athletes

PurposeThe aim of this study was to investigate whether the whole tibial spine volume and femoral intercondylar notch volume are risk factors for anterior cruciate ligament (ACL) injury. The hypothesis was that the whole tibial spine volume and femoral notch volume would be smaller in athletes who sustained ACL injury than in athletes with no history of ACL injury.MethodsComputed tomography scans of both knees were acquired and three-dimensional bone models were created using Mimics to measure whole tibial spine volume and femoral notch volume. Tibial spine volume, femoral notch volume and each of these volumes normalised by tibial plateau area were compared between the ACL-injured and the ACL-intact group.ResultsFifty-one athletes undergoing unilateral anatomical ACL reconstruction (17 female, 34 male: average age 22.0 +/- 7.5) and 19 healthy collegiate athletes with no previous knee injury (eight female, 11 male: average age 20.1 +/- 1.3) were included in this study. The whole tibial spine volume in the ACL-injured group (2.1 +/- 0.5 cm3) was 20.7% smaller than in the ACL-intact group (2.7 +/- 0.7 cm3) (p = 0.005). No differences were observed between the femoral notch volume in the ACL-injured group (9.5 +/- 2.1 cm3) and the ACL-intact group (8.7 +/- 2.7 cm3) (n.s.).ConclusionsThe main finding of this study was that the whole tibial spine volume of the ACL-injured group was smaller than the ACL-intact group. A small tibial spine volume can be added to the list of anatomical risk factors that may predispose athletes to ACL injury.Level of EvidenceLevel III.