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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2025; 35(02): 272-279
DOI: 10.1055/s-0044-1791565
Original Article

Is Trochlear Dysplasia Associated with a High Prevalence of Repaired Anterior Medial Portal Lesions in Anterior Cruciate Ligament-Deficient Knees?

Autor*innen

  • Naveen Kumar

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India

  • Pradip Ghimire

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India

  • Shrikant Shukla

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India

  • Pradeep Kumar Meena

    2   Department of Orthopedics, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India

  • Sudhir Saxena

    3   Department of Radiology, Graphic Era Institute of Medical Sciences, Dehradun, Uttarakhand, India

  • Sonal Saran 

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India

Funding None.
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Abstract

Introduction Meniscal tears, especially in the medial meniscus, are common in anterior cruciate ligament (ACL) injuries. Repaired anterior medial portal (RAMP) lesions, specific meniscal injuries associated with ACL ruptures, affect the peripheral attachment of the posterior horn of the medial meniscus. While the relationship between femoral trochlear morphology and ACL tears is established, its association with RAMP lesions remains unexplored. This study investigates the association between femoral trochlear morphology and RAMP lesions in ACL-deficient knees using magnetic resonance imaging (MRI) and evaluates MRI's accuracy against arthroscopy.

Materials and Methods This hospital-based, cross-sectional observational study was conducted in a tertiary care center over 18 months. It included 126 adult patients who underwent arthroscopic ACL reconstruction and had preoperative MRI. Variables included age, gender, body mass index, trauma nature, and various MRI parameters, including femoral trochlear morphology and presence of RAMP lesions. MRI findings were compared to arthroscopic findings to evaluate diagnostic accuracy.

Results RAMP lesions were detected in 21 participants (16.7%) via MRI and 28 participants (22.2%) via arthroscopy. MRI showed 71.4% sensitivity and 99.0% specificity for detecting RAMP lesions. No significant association was found between femoral trochlear morphology and RAMP lesions. However, medial tibial slope (TS) and posterior medial tibial bone edema (PMTBE) were significantly associated with RAMP lesions. The agreement between MRI and arthroscopy was high (Cohen's kappa = 0.773, p < 0.001).

Conclusion This study found no significant association between femoral trochlear morphology and RAMP lesions in ACL-deficient knees. Instead, medial TS and PMTBE were significant predictors. MRI proved to have high specificity but moderate sensitivity compared to arthroscopy.

Keywords

RAMP lesions - ACL deficiency - femoral trochlear morphology - medial tibial slope - MRI - arthroscopy

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


Patients' Consent

Informed consent was obtained from all individual participants included in the study.




Publikationsverlauf

Artikel online veröffentlicht:
07. Oktober 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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