Relationship between Body Mass Index and Articular Injuries Accompanying Primary Anterior Cruciate Ligament Tear in Male Knees: A Retrospective Observational Study

The objective of this study was to determine the effects of body mass index (BMI), as a modifiable risk factor, on meniscal, chondral, and ligamentous injuries, as well as on bone marrow edema accompanying anterior cruciate ligament (ACL) rupture. This retrospective observational study analyzed 84 male patients who underwent primary ACL reconstruction from 2015 to 2018. Magnetic resonance imaging was performed within 6 weeks of injury. Bone bruise, tendon, ligament, meniscal, and muscle injuries were evaluated. The surgery was performed within 3 months after the injury. Detailed arthroscopic findings (chondral, meniscal, and ligamentous injuries) were documented intraoperatively. The weight and height were used to quantify BMI (weight in kg/height in m²). Of the 84 male patients, 58 had associated articular injuries. The median age of the study population was 24 years (minimum: 17 years, maximum: 43 years) years. The mean BMI, height, and weight were 27.12 ± 0.78 kg/m², 1.73 ± 0.01 m, and 81.17 ± 21.52 kg, respectively. The relationship between higher BMI and associated articular injuries (95% confidence interval [CI]) was statistically significant (p < 0.001). There was a statistically significant relationship between weight and associated articular injuries (p = 0.003). Height and age were not predictive factors. Higher BMI and weight were significant risk factors for associated articular injuries in the presence of ACL tear. Height was not found to be a predictive factor. Higher BMI was associated with increased risk of medial and/or lateral meniscus tears and bone bruising.

The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study

Introduction:

Tibial slope angles (TSAs) have been identified as potential risk factors of anterior cruciate ligament (ACL) injury in the literature. A higher body mass index (BMI) might increase the risk of ACL tear because of greater axial compressive force. The aim of this study was to determine the relationship of these factors and the combined effect of BMI and TSA in determination of risk potential for ACL injury.

Methods:

The preoperative magnetic resonance (MR) images of 81 ACL-injured male knees and of 68 male individuals with no ACL injuries were evaluated by 2 radiologists to measure the TSA. The Mann-Whitney U-test was performed to indicate the significant difference in height, weight, and BMI values. The independent samples t-test was used to determine the differences between ACL-injured and non-injured groups regarding TSA values. Odds ratios were calculated by logistic regression tests, and receiver operating characteristics (ROC) curves revealed the area under the receiver operating characteristics curve (AUC) values to compare the relationships of these parameters with ACL injury.

Results:

Body mass index, lateral tibial slope (LTS), and medial tibial slope (MTS) were predictive of ACL risk injury. Body mass index alone had the greatest effect among these parameters, and there were no statistically significant differences in coronal tibial slope values between the ACL-ruptured and control groups. The greatest AUC was observed for the combination of BMI, MTS, and LTS.

Conclusions:

Body mass index, LTS, and MTS angles were associated with ACL injury risk and BMI + MTS + LTS together revealed the greatest effect on ACL injury.

Assessment of the anterolateral ligament of the knee by 1.5 T magnetic resonance imaging

Objective This study was performed to evaluate the visibility of the knee's anterolateral ligament (ALL) by magnetic resonance (MR) imaging when evaluating injuries of the ALL in relation to injuries of the anterior cruciate ligament (ACL). Methods Two reviewers retrospectively analyzed MR images for the visibility and dimensions of the ALL and the relationship between ALL and ACL injuries. The intraclass correlation coefficient (ICC) and kappa analysis were used to assess interobserver reliability. The chi-square test was used to assess the relationship between ALL and ACL injuries. Results The entire ALL was viewed on 82% of all MR images. The ICC for ALL visualization ranged from moderate to perfect between the two readers. There was almost perfect agreement between the reviewers when evaluating ALL dimensions. The mean length ± standard error, median thickness, and mean width ± standard error of the ALL were 36.5 ± 0.6 mm, 2.5 mm, and 8.2 ± 0.2 mm, respectively. A statistically significant relationship was observed between ALL and ACL injuries. Conclusion The ALL was visible on most MR images, allowing ALL injuries to be noted during routine MR image interpretation. Radiologists should note concomitant ACL and ALL injuries as part of their assessments.