Association between femoral notch area and patient-reported outcomes after anterior cruciate ligament reconstruction.

BACKGROUND

Bone morphology is a key intrinsic factor in anterior cruciate ligament (ACL) injury. This study aimed to evaluate the impact of femoral notch area (FNA) on functional outcomes after ACL reconstruction (ACLR).

METHODS

This single-center retrospective study was conducted on 68 patients (62 men and 6 women). Data on age, sex, body mass index (BMI), and follow-up duration of patients were recorded. FNA and morphologic measurements were obtained. Patient-reported outcome measures included the International Knee Documentation Committee score (IKDC), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and Tegner Activity Scale (TAS) assessed at a minimum of 24 months postoperatively. The correlation between variables was examined using Spearman correlation, linear, and ordinal regression analyses. A p-value < 0.05 was considered statistically significant.

RESULTS

The mean age of the patients was 28.9 ± 7.8 years, and the mean follow-up period was 32.2 ± 5.0 (min–max: 25–39) months. A negative correlation was found between BMI and IKDC (r = − 0.363; p = 0.002) and TAS (r = − 0.436; p = 0.001). Statistically significant correlations were found between FNA and IKDC (p = 0.001), KOOS (p = 0.001), and TAS (p = 0.021). ROC analysis identified an FNA cut-off value of 42.2 mm² associated with a favourable IKDC outcome (≥ 75.9), although discrimination was modest (AUC = 0.635).

CONCLUSIONS

Femoral notch area was associated with patient-reported outcomes after ACL reconstruction; however, its predictive value was limited. Additionally, an increase in BMI scores negatively impacted patients’ IKDC and TAS scores after ACLR. LEVEL OF EVIDENCE: III, retrospective cohort study.