The predictive value of radiographs in the evaluation of unilateral and bilateral anterior cruciate ligament injuries

Abstract

A review of 250 cases of surgical reconstruction of the anterior cruciate ligament identified 24 patients with bilateral complete tears of the anterior cruciate liga ment. Twenty of these patients had previous recon struction of one anterior cruciate ligament before rup ture of the opposite ligament. Twelve injuries occurred during the same activity that was responsible for the initial opposite injury. The average time between sur gical reconstruction and rupture of the opposite liga ment was 29.3 months (range, 3 to 103). No significant demographic differences existed between patients with unilateral or bilateral ruptures of the anterior cruciate ligament. Standardized measurements of intercondylar notch height and width and medial and lateral femoral condyle height and width were performed on routine notchview radiographs of 31 knees of patients with bilateral inju ries, 30 with unilateral injury, and 30 with no anterior cruciate ligament injury. Statistical analysis revealed no significant differences between the three groups when comparing absolute measures or any of eight mathe matical ratios calculated from these measurements. We concluded that measurements of the intercondylar notch made from radiographs may not be reliable pre dictors of injury to the anterior cruciate ligament. We found no significant clinical or demographic differences between patients with unilateral or bilateral complete ruptures of the anterior cruciate ligament.