Patients with ACL injury have lower and more posterior position of proximal tibiofibular joint than patients with intact ACL.

Abstract

Background: Knees with anterior cruciate ligament (ACL) injury have distinct knee bone morphology. However, the correlation between ACL injury and morphology of the proximal tibiofibular joint has not been investigated.

Purpose: To compare proximal tibiofibular joint morphology in patients with injured and intact ACLs to aid in predicting and preventing ACL injuries.

Material and methods: A total of 50 patients with ACL injury and 50 individuals without structural knee damage (revealed by magnetic resonance imaging [MRI]) were included in this study. In the anteroposterior knee radiographs, the length between the proximal end of the fibular head and the medial and lateral tibia joint line were measured. In the axial knee MRI scans with the most proximal part of the fibular head, the distance calculation was performed between the most anterior point of the tibia plateau (MATP) and the most anterior point of fibular head (MAFH).

Results: The mean length from the proximal end of the fibular head and the medial and lateral tibial joint lines was 8.7 ± 2.8 mm and 13.2 ± 2.6 mm in the ACL-injured group, and 6.5 ± 2.8 mm and 11.1 ± 2.4 mm in the control group. The length for both medial and lateral sides was significantly greater in the ACL-injured group. The length between the MATP and MAFH was significantly larger in the ACL-injured group than the control group.

Conclusion: A large distance between the proximal end of the fibular head and the tibial joint line and knees with posterior fibular head placement would be another anatomic risk factor of ACL injury.