Clinical-Grade MRI-Based Methods to Identify Combined Anatomic Factors That Predict ACL Injury Risk in Male and Female Athletes. Issue 10 (August 2021)

• Record Type: Journal Article
• Authors: Beaulieu, Mélanie L.; Nowak, Emma K.; Beynnon, Bruce D.; Ashton-Miller, James A.; Sturnick, Daniel R.; Wojtys, Edward M.
• Is Part Of: American journal of sports medicine. Volume 49:Issue 10(2021)
• Page Start: 2615
• Page End: 2623
• Publication Date: 2021-08
• Subjects: anterior cruciate ligament injury -- risk factors -- knee anatomy; Sports medicine -- Periodicals; Sports injuries -- Periodicals; Orthopedic surgery -- Periodicals; 617.102705
• DOI: 10.1177/03635465211024249
• Languages: English
• ISSNs: 0363-5465

Abstract

Background: Recently developed multivariate sex-specific statistical models can predict anterior cruciate ligament (ACL) injury risk using various knee anatomic factors. However, screening tools able to identify individuals at an increased injury risk are unlikely to be developed based on these models, given that sophisticated and time-consuming methods were used to measure those factors on research-grade resolution magnetic resonance images (MRIs). Purpose: To determine whether simpler methods, amenable to using clinical-grade resolution MRIs, can identify the same knee anatomic factors previously found to contribute to ACL injury risk using sophisticated methods and research-grade resolution images. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: High-resolution 3-dimensional MRIs previously acquired from 87 patients with primary, noncontact, grade III ACL injury and 87 uninjured matched control participants for a series of published studies were downgraded to clinical-grade resolution images. The 4 knee anatomic factors found to contribute to ACL injury risk in women and in men in these published studies—femoral intercondylar notch width at the anterior outlet of the ACL (NW_O), posterior-inferior directed slope of the middle region articular cartilage surface of the tibial plateau's lateral compartment (Lat Tib MCS), ACL volume, and tibial plateau's lateral compartment posterior meniscus to subchondral bone wedge angle (Lat Tib MBA)—were measured using clinical-grade resolution MRI-based methods. Stepwise multivariate conditional logistic regressions were used to identify the combinations of factors most highly associated with an ACL injury risk in women and men separately. Results: The multivariate model that best predicted ACL injury risk in the female participants included the Lat Tib MCS and the NW_O. For the male participants, this model included the ACL volume and the Lat Tib MBA. These results corroborate the previously published results that reported models with the same knee anatomic factors to best predict injury risk in this group of young women and men. Conclusion: Simpler methods using MRIs downgraded to a clinical-grade resolution can identify the same knee anatomic factors previously found to significantly contribute to ACL injury risk using sophisticated methods and research-grade resolution MRIs.