Mandler Elisabeth, Kainberger Franz, Hirtler Lena
Center for Anatomy and Cell Biology, Medical University of Vienna, 1090 Vienna, Austria.
Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2025 Jun 25;14(13):4513. doi: 10.3390/jcm14134513.
The intercondylar notch (IN) houses the central ligaments of the knee joint, namely the anterior and posterior cruciate ligaments (ACL and PCL) as well as the anterior and posterior meniscofemoral ligaments (aMFL and pMFL). As not only the available intercondylar space directly influences the encased ligaments, but also the ligaments themselves may influence each other, the purpose of this study was to evaluate the influence of osteoarthritis on central ligament morphology. Imaging data from the osteoarthritis initiative was used to assess 415 randomly selected patients, equally distributed across five groups based on osteoarthritis severity using the Kellgren and Lawrence classification. MRI scans were used to measure ligament structures in the coronal, axial and sagittal planes. The ACL was evaluated and classified into healthy, pathologic and ruptured. The relationship between osteoarthritis severity and the shape of the IN (A-shape, inverse-U-shape and Ω-shape) was analyzed in relation to ligament morphometrics and ACL condition. The morphology of the ligaments is directly influenced by the development of osteoarthritis. In particular, the Ω-shape, which is associated with severe-grade osteoarthritis, is a risk factor for the development of ACL rupture ( < 0.001). But also, the condition of the ACL influenced the morphometrics of the posterior ligaments, and the PCL as well as the MFLs influenced each other. Statistically significant morphological changes to the encased ligaments in the intercondylar space in osteoarthritis were reported. In particular, the ACL shows a higher risk for pathological changes during ongoing joint degeneration due to osteoarthritis. The other evaluated ligaments-MFLs and PCL-are influenced by the condition of the osseous structures and the shape of the IN as well as by the condition and continuity of the ACL.
髁间切迹（IN）容纳膝关节的中央韧带，即前交叉韧带和后交叉韧带（ACL和PCL）以及前后半月板股骨韧带（aMFL和pMFL）。由于不仅可用的髁间间隙直接影响所包裹的韧带，而且韧带本身也可能相互影响，因此本研究的目的是评估骨关节炎对中央韧带形态的影响。来自骨关节炎倡议组织的影像数据用于评估415名随机选择的患者，根据骨关节炎严重程度使用凯尔格伦和劳伦斯分类法将他们平均分为五组。MRI扫描用于测量冠状面、轴位和矢状面的韧带结构。对ACL进行评估并分为健康、病理和断裂三类。分析了骨关节炎严重程度与IN的形状（A形、倒U形和Ω形）之间的关系，并与韧带形态测量学和ACL状况相关联。韧带的形态直接受到骨关节炎发展的影响。特别是，与重度骨关节炎相关的Ω形是ACL断裂发生的危险因素（<0.001）。此外，ACL的状况也影响后韧带的形态测量，PCL以及MFLs之间也相互影响。报告了骨关节炎患者髁间间隙中所包裹韧带的统计学显著形态学变化。特别是，由于骨关节炎导致的关节持续退变期间，ACL发生病理变化的风险更高。其他评估的韧带——MFLs和PCL——受到骨结构状况、IN的形状以及ACL的状况和连续性的影响。
