2025 ISAKOS Biennial Congress ePoster
Lateral femoral impaction fractures during an ACL tear extend posteriorly on the weight-bearing area of the tibiofemoral joint.
Marcin Mostowy, MD, Łódź POLAND
Kacper Ruzik, MD, Lodz POLAND
Krzysztof Starszak, MD, Lodz POLAND
Grzegorz Maciąg POLAND
Pawel Piotr Skowronek, MD, PhD, Krakow POLAND
Michael T. Hirschmann, MD, Prof., Bruderholz SWITZERLAND
Robert F. LaPrade, MD, PhD, Edina, MN UNITED STATES
Przemyslaw Pekala, Krakow POLAND
Dong Woon Kim, MS, Krakow POLAND
Konrad Malinowski, PhD, Belchatow POLAND
Artromedical Orthopaedic Clinic, Belchatow, POLAND
FDA Status Not Applicable
Summary
This study confirms posterior elongation of the physiological terminal sulcus (TS) due to lateral femoral condyle (LFC) impaction fracture after ACL tear, which could potentially decrease the weight-bearing area of the joint, decrease the tension on lateral meniscus and cause LFC flattening, influencing rotational knee motion and causing anisometry of lateral and anterolateral stabilizers.
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Abstract
Purpose
Posterior elongation of the physiological terminal sulcus (TS) due to lateral femoral condyle impaction fracture (LFC-IF) after an ACL tear could potentially decrease the weight-bearing area of the tibiofemoral joint, decrease the tension on lateral meniscus and cause flattening of the LFC which would influence rotational knee motion and cause anisometry of the lateral and anterolateral stabilizers. Therefore, the purpose of the study was to assess if the LFC-IF elongates the physiological TS posteriorly.
Methods
100 patients MRIs (75 males, 25 females, mean age 32.2 years, SD=8.2) were included with a 1:1 ratio between the full-thickness ACL tear group and the control group (patients with knee MRI performed due to other reasons, with no tear of ACL on MRI and negative clinical tests). Two independent raters evaluated the sagittal T1-weighted pre-selected MRI scans. The principal measurement of interest was the distance from the intersection of the Blumensaat line with subchondral bone to the posterior border of the TS/LFC–IF.
Results
The median distance from the Blumensaat line to the posterior border of the TS/LFC-IF was significantly higher in the ACL tear group: 14.3 mm, IQR=11.6-16.4 mm vs. control group: 12.8 mm, IQR=9.0-15.0 mm, p=0.038. Intra- and inter-rater reliabilities were>0.90.
Conclusion
Lateral femoral condyle impaction fracture (LFC-IF) after full-thickness ACL tear significantly elongates the physiological terminal sulcus (TS) in the posterior direction.