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A novel morphological classification for the femoral notch based on MRI: a simple and effective assessment method for the femoral notch

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A Correction to this article was published on 27 December 2019

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Abstract

Objective

To propose a novel morphological classification method for notches, which may provide new evidence for notchplasty based on the three-dimensional (3D) features of notches and the risk of anterior cruciate ligament (ACL) injury.

Materials and methods

Three hundred individuals in total were included in our study, including 150 patients with ACL ruptures (75 males and 75 females) and 150 age- and gender-matched individuals without ACL ruptures. The notches were divided into four types according to the notch widths at the notch inlet, outlet, and ACL attachment based on the preoperative MRI, the notch volume was calculated, and the risk of ACL injury was compared. The surgical records were reviewed and whether these cases performed notchplasty were collected.

Results

The inlet-and-outlet stenosis notch type was associated with smaller notch volume (P = 0.007) and a higher risk of ACL injury (P < 0.001). There were no significant differences in morphological distribution between males and females. The rate of notchplasty in inlet-and-outlet stenosis type was higher than the others.

Conclusions

The new morphological classification method efficiently reflected the association of the notch shape with the 3D notch volume and the risk of ACL injury. The knees with the inlet-and-outlet stenosis notch type and smaller notch volume tended to have a higher risk of ACL injury.

Level of evidence Level III, case-control study.

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Change history

  • 27 December 2019

    Unfortunately in Volume 49, Issue 1 had been published online with an incorrect date (2001 instead of 2020).

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Acknowledgements

The authors would like to thank Dr. **ao’er Wei from radiology department, Shanghai Sixth People’s Hospital, Shanghai, China for technical guidance; and we thank Ms. Yujun Xu from Ludwig Maximilian University of Munich for statistical guidance; and we also thank Dr. Xuancheng Zhang and Zhaoyi Fang from Department of Sports Medicine, Shanghai Sixth People’s Hospital, Shanghai, China, and Dr. Feng Wang from Department of Sports Medicine, Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai China for assistance.

Funding

1. The Western Medicine Guidance Project of Science and Technology Commission of Shanghai Municipality of China (Grant No. 17411966400).

2. The Project of Shenkang Hospital Development Center of Shanghai (Grant No. 16CR3108B).

3. The project of Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Sciences (Grant No. DY2018010).

4. Domestic science and technology cooperation projects of Science and Technology Commission of Shanghai Municipality ‘Training on the diagnosis and treatment of early and middle stage knee osteoarthritis with minimally invasive arthroscopy’ (Grant No. 18695840100).

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Author notes

  1. Chengyuan Zhang, Shikui Dong, and Chang’an Chen contributed equally to this work and should be considered co-first authors

  2. Guoming **e and **zhong Zhao contributed equally to this work and should be considered co-corresponding authors.

Authors and Affiliations

  1. Department of Orthopedics, Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Sciences, Pudong New Area, Shanghai, 201306, People’s Republic of China

    Chengyuan Zhang

  2. Department of Orthopedics, Shanghai Sixth People’s Hospital, Xuhui District, Shanghai, 200233, People’s Republic of China

    Guoming **e, Shikui Dong, Chang’an Chen, **aochun Peng & **zhong Zhao

  3. Department of Sports Medicine, Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, 201306, People’s Republic of China

    Feng Yuan

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  1. Chengyuan Zhang
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Correspondence to Guoming **e.

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This study was approved by Ethics Committee of Shanghai Sixth People’s Hospital (Approval No: 2016–111).

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Zhang, C., **e, G., Dong, S. et al. A novel morphological classification for the femoral notch based on MRI: a simple and effective assessment method for the femoral notch. Skeletal Radiol 49, 75–83 (2020). https://doi.org/10.1007/s00256-019-03255-4

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