Patients with mucoid ACL hypertrophy show a narrower notch, a steeper notch angle, and a smaller notch area

The intercondylar notch width, notch index (width of intercondylar notch/width of femoral condyle), transverse notch angle (TNA), sagittal notch angle (SNA), and notch area are recorded on axial and sagittal MR images at the midpoint of Blumensaat’s line which is identified on sagittal images.

The diameter of the ACL is recorded on coronal MR images at the posterior end of Blumensaat’s line.

The mean values of the intercondylar notch width, notch index, TNA, SNA, notch area, and ACL diameter are

16.0 mm/0.2/50.3 degrees /36.5 degrees /249.0 mm(2)/7.7 mm (group 1);

19.3 mm/0.3/52.9 degrees /40.2 degrees /323.4 mm(2)/4.8 mm (group 2); and

20.3 mm/0.3/51.4 degrees /39.1 degrees /350.8 mm(2)/4.5 mm (group 3).

The intercondylar notch width, notch index, SNA, and notch area is smaller, and ACL diameter is thicker in group 1 compared with the other groups (p < 0.05).

Athletes with smaller ACLs may be more susceptible to injury

People with torn ACLs are more likely to have a smaller ligament than similarly-sized people who have never injured a knee.

The smaller the intercondylar notch the smaller the cross-sectional area of the ACL midsubstance. In addition to the impingement of the ACL at the anterior and posterior roof of the notch, a biomechanically weaker ACL may be the reason for disposition to an ACL rupture in patients with a small intercondylar notch.

High resolution MR imaging performed on a 1.5 T magnet using a dedicated extremity-coil shows women to have a thinner ACL midsubstance than men of the same height which may be one of the critical etiologic factors that predispose women to an ACL rupture.

We are already to confirm(performing hundreds of reconstruction) that there is a statistical difference in femoral notch and anterior cruciate ligament volumes between men and women, which, in turn, is related to differences in height and weight.