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Skeletal Radiology
Published in: Skeletal Radiology 11/2017

01-11-2017 | Scientific Article

Acute non-contact anterior cruciate ligament tears are associated with relatively increased vastus medialis to semimembranosus cross-sectional area ratio: a case-control retrospective MR study

Authors: Ged G. Wieschhoff, Jacob C. Mandell, Gregory J. Czuczman, Violeta Nikac, Nehal Shah, Stacy E. Smith

Published in: Skeletal Radiology | Issue 11/2017

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Abstract

Objective

Hamstring muscle deficiency is increasingly recognized as a risk factor for anterior cruciate ligament (ACL) tears. The purpose of this study is to evaluate the vastus medialis to semimembranosus cross-sectional area (VM:SM CSA) ratio on magnetic resonance imaging (MRI) in patients with ACL tears compared to controls.

Materials and methods

One hundred knee MRIs of acute ACL tear patients and 100 age-, sex-, and side­matched controls were included. Mechanism of injury, contact versus non-contact, was determined for each ACL tear subject. The VM:SM CSA was measured on individual axial slices with a novel method using image-processing software. One reader measured all 200 knees and the second reader measured 50 knees at random to assess inter-reader variability. The intraclass correlation coefficient (ICC) was calculated to evaluate for correlation between readers. T-tests were performed to evaluate for differences in VM:SM CSA ratios between the ACL tear group and control group.

Results

The ICC for agreement between the two readers was 0.991 (95% confidence interval 0.984–0.995). Acute ACL tear patients have an increased VM:SM CSA ratio compared to controls (1.44 vs. 1.28; p = 0.005). Non-contact acute ACL tear patients have an increased VM:SM CSA ratio compared to controls (1.48 vs. 1.20; p = 0.003), whereas contact acute ACL tear patients do not (1.23 vs. 1.26; p = 0.762).

Conclusion

Acute non-contact ACL tears are associated with increased VM:SM CSA ratios, which may imply a relative deficiency in hamstring strength. This study also demonstrates a novel method of measuring the relative CSA of muscles on MRI.
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Metadata
Title
Acute non-contact anterior cruciate ligament tears are associated with relatively increased vastus medialis to semimembranosus cross-sectional area ratio: a case-control retrospective MR study
Authors
Ged G. Wieschhoff
Jacob C. Mandell
Gregory J. Czuczman
Violeta Nikac
Nehal Shah
Stacy E. Smith
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 11/2017
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-017-2709-3

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