Intercondylar Notch Stenosis is not a Risk Factor for Anterior Cruciate Ligament Tears in Professional Male Basketball Players

Abstract

Background The value of femoral notch size and the notch width index in predicting anterior cruciate ligament injury has been debated. This study examined the relationship between the notch width index and anterior cruciate ligament injury in professional basketball players. Hypothesis No significant difference exists between the notch width index of anterior cruciate ligament–injured and noninjured professional basketball players. Study Design Case-control study; Level of evidence, 3. Methods Using a notch view radiograph, the authors prospectively measured the femoral notch and the condylar widths and then calculated the notch width index of 615 male athletes who participated in the National Basketball Association's combine workouts between 1992 and 1999. Players who participated in at least 1 professional game were included. After an 11-year follow-up period, the National Basketball Association's leaguewide injury database was reviewed to identify injured players. The players were then categorized into anterior cruciate ligament–injured or noninjured groups. Notch width, condylar width, and notch width index were compared between the 2 groups. Results A total of 305 players were followed for a period of up to 11 years. Anterior cruciate ligament trauma was suffered by 14 (4.6%) of the subjects. The average notch width index was 0.235 ± 0.031 for anterior cruciate ligament–injured players and 0.242 ± 0.041 for noninjured players (t305 –0.623, P=. 534). This difference was not significantly different. Two (3.9%) of the subjects with critical notch stenosis (notch width index 0.20) had noncontact anterior cruciate ligament injuries. Conclusions The notch width index did not predict the rate of anterior cruciate ligament injury. A level of critical notch stenosis was not detected. Anterior cruciate ligament injury could not be predicted by the absolute measurement of the femoral intercondylar notch. Use of a preparticipation notch view radiograph in male professional basketball players as a predictor of anterior cruciate ligament injury is not recommended.