Imaging And Anatomy Study Of Femoral Intercondylar Notch And Its Clinical Significance

Objective:To analyse the difference between CT and X-ray and direct measurement by measuring the intercondylar notch of human skeletal bone;CT and X-ray measurements by arthroscopic examination of patients with chronic ACL injury in patients with preoperative condylar intercostal fissure,The reliability of intercostal space stenosis and its clinical significance.Methods:1.A complete specimen of 69 adult human femur was provided by the Department of Anatomy of Yanbian University.The width of the intercondylar notch width(ICW),notch width index(NWI),the intercondylar notch width(the articular surface of the intercondylar notch),the intercondylar notch width(2/3 height of the intercondylar notch),femoral condylar width and condylar angle was measured on the images obtained by X-ray and CT,and at the same time,the intercondylar notch was classified by three methods,comparison of CT and X-ray and direct measurement of the difference.2.A total of 90 patients with chronic ACL injury with the existence of unilateral lateral condylar stenosis caused was confirmed by arthroscopy from March 2016 to December 2016 in the Department of Bone and Joint Surgery and Sports Medicine of Affiliated Hospital of Yanbian University.All patients underwent CT and X-ray before surgery,The ICW and NWI of the intercondylar notch were measured and calculated on the obtained images,the measured values between the groups were compared with the standard values of bone specimens,and the intercondylar notch was classified and compared by sex.Results:1.In the bone specimen survey,there was no significant difference between the direct measurement and the CT measurement(P>0.05).There was significant difference between the direct measurement and the x-ray measurement(P<0.05)except the notch width index(NWI)of the intercondylar notch,the three types of condylar notch were completely consistent.2.In the clinical case measurement,CT:the intercondylar notch width(ICW)was 16.68±1.03mm,which was significantly lower than the standard value 18.51mm(P<0.05).The notch width index(NWI)was 0.22±0.02.which was significantly lower than the standard value 0.24(P<0.05).X-ray:The width(ICW)of the intercondylar notch was 16.87±1.05mm,which was significantly lower than the standard value 19.18mm(P<0.05).The notch width index(NWI)was 0.22± 0.02,which was significantly lower than that of the standard 0.24(P<0.05).According to NWI standard values and measured values,CT determined 77 cases(86%)with intercondylar notch stenosis;X-ray determined 68 cases(76%)with intercondylar notch stenosis.CT and arthroscopic classification of intercondylar notch was consistent and the difference between the X-ray and the first two cases was slightly different.There was a significant difference in the type of intercondylar notch between male and female patients.Female A-type and W-type intercondylar fissure than the proportion of male,male U-shaped intercondylar notch than the proportion of women.Conclusion:CT is a reliable imaging method for the measurement of femoral condyle space and the prediction of intercondylar notch stenosis.Although X-ray is not as accurate and stereoscopic as CT,it still has some reference value.Imaging findings of femoral condylar space NWI and observation of the shape of the intercondylar notch to predict the risk of ACL injury has important clinical significance.