Karakteristik Anatomis berupa Notch width Index dan Bentuk Femoral Notch pada Pasien dengan Cedera Anterior Cruciate Ligament di RSUP H Adam Malik

Abstract

ABSTRACT Background: Anterior cruciate ligament (ACL) injury is one of the most common knee injuries that causes instability, pain, and functional limitations, often requiring surgical reconstruction. Anatomical factors such as the intercondylar notch morphology, including the Notch Width Index (NWI) and femoral notch shape, have been proposed as intrinsic risk factors for ACL rupture. A narrow or stenotic notch is believed to increase mechanical impingement on the ACL, predisposing it to injury. Objective: To describe the anatomical characteristics of the Notch Width Index (NWI) and femoral notch shape in patients with ACL injury at H. Adam Malik General Hospital, Medan. Methods: This descriptive observational study involved 64 patients diagnosed with ACL injury confirmed by MRI between 2023 and 2024. Data were obtained from medical records and MRI images, including patient demographics, NWI values, and femoral notch morphology (A-type, U-type, or W-type). Measurements were performed using sagittal and coronal MRI slices. Data were analyzed descriptively using SPSS version 29. Results: Of the 64 patients, 46 (71.9%) were male and 18 (28.1%) female, with a mean age of 27.75 ± 8.35 years. The most frequent mechanism of injury was sports-related trauma (64.1%), followed by falls (18.8%) and traffic accidents (17.2%). The mean NWI among ACL-injured patients was 0.23 ± 0.04. Morphological analysis showed that the U-type notch was most common (56.2%), followed by A-type (10.9%) and W-type (32.9%). Conclusion: The majority of ACL injury patients exhibited a U-type femoral notch and a relatively low Notch Width Index, supporting the theory that narrower intercondylar notch dimensions may contribute to ACL injury risk. These findings underline the importance of anatomical evaluation in identifying individuals at higher risk of ACL rupture. Keywords: anterior cruciate ligament, ACL injury, femoral notch shape, notch width index, MRI, knee anatomy.