Evidence map›Paper›PMID 32974801›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021

The deep lateral femoral notch sign: a reliable diagnostic tool in identifying a concomitant anterior cruciate and anterolateral ligament injury.

Dimitris Dimitriou, Matthias Reimond, Andreas Foesel, Bodo Baumgaertner, Diyang Zou, Tsung-Yuan Tsai, Naeder Helmy

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05682820 (Analysis of Radiological Features of Lateral Femoral Impaction Fracture / Lateral Femoral Notch Sign), which is not on this map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05682820 unknown statusnot on this map

Analysis of Radiological Features of Lateral Femoral Impaction Fracture / Lateral Femoral Notch Sign

TypeobservationalSponsorArtromedical Konrad Malinowski ClinicRan2020 to 2024Enrolled100ConditionsAnterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Rupture, Anterior Cruciate Ligament TearArmsMeasurements on knee MRI performed during routine clinical practice
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 23 citations in OpenAlex.

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  14. Current trends in the anterior cruciate ligament part 1: biology and biomechanics.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
    Review
  15. [Research progress of lateral femoral notch sign in diagnosis of anterior cruciate ligament rupture].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Dimitris DimitriouDepartment of Orthopaedics Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.
Matthias ReimondDepartment of Orthopaedics Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.
Andreas FoeselDepartment of Orthopaedics Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.
Bodo BaumgaertnerDepartment of Orthopaedics Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.
Diyang ZouEngineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China.
Tsung-Yuan TsaiEngineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China. tytsai@sjtu.edu.cn.ORCID http://orcid.org/0000-0003-1522-2987
Naeder HelmyDepartment of Orthopaedics Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.
Solothurner Spitäler · CHShanghai Jiao Tong University · CN

Funding

Key Technologies Research and Development Program 2017YFC0110700Key Technologies Research and Development Program 2019YFC010262Key Technologies Research and Development Program 2019YFC0120601the Innovation Research Plan supported by Shanghai Municipal Education Commission ZXWF082101the National Natural Science Foundation of China 31771017the National Natural Science Foundation of China 31972924the Science and Technology Commission of Shanghai Municipality 16441908700
6 · The paper itself

Abstract

purposeThe aim of the present study was to investigate the validity and reliability of the deep lateral femoral notch sign (DLFNS) in identifying a concomitant anterior cruciate ligament (ACL)/anterolateral ligament (ALL) rupture and predicting the clinical outcomes following an anatomical single-bundle ACL reconstruction. It was hypothesized that patients with a concomitant ACL/ALL rupture would have an increased DLFNS compared to patients without a concomitant ACL/ALL rupture.

methodsThe lateral preoperative radiographs and MRI images of 100 patients with an ACL rupture and 100 control subjects were evaluated for the presence of a DLFNS and ACL/ALL rupture, respectively. The patients were evaluated clinically preoperatively and at a minimum 1 year following the ACL reconstruction. A receiver operator curve (ROC) analysis was performed to define the optimal cut-off value of the DLFNS for identifying a concomitant ACL/ALL injury. The relative risk (RR) was also calculated to determine whether the presence of the DLFNS was a risk factor for residual instability or ACL graft rupture following an ACL reconstruction.

resultsThe prevalence of DLFNS was 52% in the ACL-ruptured patients and 15% in the control group. At a minimum 1-year follow-up, 35% (6/17) of the patients with DLFNS > 1.8 mm complained of persistent instability, and an MRI evaluation demonstrated a graft re-rupture rate of 12% (2/17). In patients with a DLFNS < 1.8 mm, 8% (7/83) reported a residual instability, and the graft rupture rate was 2.4% (2/83). A DLFNS > 1.8 mm demonstrated a sensitivity of 89%, a specificity of 95%, a negative predictive value of 98%, and a positive predictive value of 89% in identifying a concomitant ACL/ALL rupture. Patients with a DLFNS > 1.8 mm had 4.2 times increased risk for residual instability and graft rupture compared to patients with a DLFNS ≤ 1.8 mm.

conclusionsA DLFNS > 1.8 mm could be a clinically relevant diagnostic tool for identifying a concomitant ACL/ALL rupture with high sensitivity and PPV. Patients with a DLFNS > 1.8 mm should be carefully evaluated for clinical and radiological signs of a concomitant ACL/ALL rupture and treated when needed with a combined intra-articular ACL reconstruction and extra-articular tenodesis to avoid a residual rotational instability and ACL graft rupture. LEVEL OF EVIDENCE: III.

Indexed as

AdolescentAdultAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionFemaleFemurHumansLigamentsMagnetic Resonance ImagingMaleRadiographyReproducibility of ResultsRetrospective StudiesRuptureTenodesisYoung AdultAnterior cruciate ligamentAnterolateral ligamentClinical outcomesDeep lateral femoral notch signRadiograph

Identifiers

PMID32974801
OpenAlexW3087920861

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.