Relationship between Femoral Intercondylar Notch Narrowing on Radiography and Anatomical and Histopathologic Integrity of Anterior Cruciate Ligament in Patients Undergoing Total Knee Replacement Surgery

Abstract Introduction: The presence of cruciate ligaments are very important for normal knee kinematics. Knee arthroplasty prostheses, in which these ligaments are maintained, have better kinematics. The aim of the present study was to investigate the association between femoral intercondylar notch narrowing in radiography and clinical and histopathologic integrity of anterior cruciate ligament (ACL) in patients undergoing knee replacement surgery. Materials and methods: 102 candidates of knee replacement surgery were enrolled. In tunnel view radiography of the knees, femoral intercondylar notch (FIN) index was measured. During total knee arthroplasty (TKA), the anatomical status of ACL was examined. Then, ACL was removed and sent for histopathologic examination to assess ligament`s degeneration rate. The association between the femoral intercondylar notch index and the clinical and histopathological health of ACL was investigated. Results: in 102 patients with mean age of 69.73 ± 7.81 years , 39 patients (38.32%) had no or torn ACL, 31 patients (30.39%) had weak ACL, and 32 (31.37%) had normal ACL. There was a significant association between age and clinical status of ACL during surgery. There was a significant difference in FIN and ACL health status during surgery between the two groups with an index of more and less than 0.252. There was no significant difference in mean total degeneration score (TDS) of ACL between the two groups with FIN more and less than 0.252. Conclusion: There was a significant difference between the age and FIN narrowing (less than 0.252) and ACL clinical status during surgery. FIN narrowing had no significant effect on the severity of ACL degeneration and there was no significant difference in the severity of degenerative histopathologic changes between healthy and attenuated ACLs. This indicates that if ACL exists, although apparently attenuated, it has the histologic characteristic of a healthy ligament