{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T02:53:03Z","timestamp":1781491983677,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["Grant No. 82474537"],"award-info":[{"award-number":["Grant No. 82474537"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantitatively assess intercondylar notch morphometrics using 3\u2010dimensional computed tomography reconstruction, evaluate their association with anterior cruciate ligament (ACL) injury in Asian populations, and investigate the prevalence of osteophytes in patients with ACL injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included patients aged 18 to 50\u2009years with knee symptoms who underwent magnetic resonance imaging and computed tomography at our hospital between September 2023 and September 2024. Exclusion criteria included moderate\u2010to\u2010severe osteoarthritis (Kellgren\u2010Lawrence grade \u22652), multiligament injuries, and prior knee surgery. Patients were divided into ACL injury and non\u2010ACL injury groups. Computed tomography parameters included notch width index, notch width, notch height, bicondylar width, notch angle, \u03b2 angle, and osteophytes. Reliability was assessed using the intraclass correlation coefficient. Group comparisons and associations were evaluated using appropriate parametric\/nonparametric tests,\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      tests, and univariate\/multivariable logistic regression, with multicollinearity diagnostics and model performance evaluation (including receiver operating characteristic curve analysis, calibration\/discrimination, incremental value, sensitivity analysis, nomogram construction, decision curve analysis, and SHapley Additive exPlanations analysis).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 146 patients with activity\u2010related knee discomfort (ACL injury, n\u2009=\u200983; controls, n\u2009=\u200963) were included. Intraobserver and interobserver reliability were excellent (intraclass correlation coefficients 0.95\u20100.98 and 0.98\u20100.99, respectively). Osteophytes (odds ratio [OR]\u2009=\u20097.41; 95% confidence interval, 2.89\u201018.98;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), age (OR\u2009=\u20090.940;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), notch angle (OR\u2009=\u20090.84;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and \u03b2 angle (OR\u2009=\u20091.15;\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u2009.02) were associated with ACL injury. Receiver operating characteristic curve analysis showed the full model, including osteophytes (area under the curve\u2009=\u20090.86), outperformed the model without osteophytes (area under the curve\u2009=\u20090.81). Sex was not associated with osteophyte incidence or notch width index (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u2009.05). Weight, height, notch height, and bicondylar width were not associated with ACL injury (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study showed that specific intercondylar notch morphometric features, particularly osteophytes and notch angle, were strongly associated with ACL injury in this Asian cohort. \u03b2 angle, notch width index, and age were also associated with ACL injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, case\u2010control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70383","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T02:30:19Z","timestamp":1781490619000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computed Tomography\u2010Based Morphometric Analysis Reveals Intercondylar Notch Stenosis and Osteophytes Are Associated With Anterior Cruciate Ligament Injury"],"prefix":"10.1002","author":[{"given":"Xiaozhong","family":"Ma","sequence":"first","affiliation":[{"name":"The First Clinical Medical College Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WenMing","family":"Jiang","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiology Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Province Hospital of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongyue","family":"Ji","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Yan","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Zhu","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Province Hospital of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Province Hospital of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Province Hospital of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5715-1035","authenticated-orcid":false,"given":"Luning","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"917","article-title":"Anterior cruciate ligament injury: Diagnosis, management, and prevention","volume":"82","author":"Cimino F","year":"2010","journal-title":"Am Fam Physician."},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/0363546505284183","article-title":"Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors","volume":"34","author":"Hewett TE","year":"2006","journal-title":"Am J Sports Med."},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s00167-009-0813-1","article-title":"Prevention of non\u2010contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors","volume":"17","author":"Alentorn\u2010Geli E","year":"2009","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1016\/j.arthro.2015.04.088","article-title":"An evaluation of the association between radiographic intercondylar notch narrowing and anterior cruciate ligament injury in men: The notch angle is a better parameter than notch width","volume":"31","author":"Alentorn\u2010Geli E","year":"2015","journal-title":"Arthroscopy."},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1007\/s00276-020-02496-6","article-title":"Correlation between notch width index assessed via magnetic resonance imaging and risk of anterior cruciate ligament injury: An updated meta\u2010analysis","volume":"42","author":"Li Z","year":"2020","journal-title":"Surg Radiol Anat."},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1177\/0363546510367424","article-title":"Association of noncontact anterior cruciate ligament injury with presence and thickness of a bony ridge on the anteromedial aspect of the femoral intercondylar notch","volume":"38","author":"Everhart JS","year":"2010","journal-title":"Am J Sports Med."},{"key":"e_1_2_10_8_1","first-page":"e55463","article-title":"Evaluation of bony femoral morphological parameters in anterior cruciate ligament injury using magnetic resonance imaging: A retrospective unmatched case\u2010control study","volume":"16","author":"Maheshwari S","year":"2024","journal-title":"Cureus."},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jcot.2021.01.006","article-title":"The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width, notch width index, notch shape \u2010 A randomized control study","volume":"17","author":"Fahim S","year":"2021","journal-title":"J Clin Orthop Trauma."},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1186\/s13018-022-03451-4","article-title":"Intercondylar notch volume in patients with posterior cruciate ligament tears and tibial avulsion injuries: A study applying computed tomography","volume":"17","author":"Huang W","year":"2022","journal-title":"J Orthop Surg Res."},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"2960","DOI":"10.4103\/0366-6999.247207","article-title":"Anatomical risk factors of anterior cruciate ligament injury","volume":"131","author":"Shen L","year":"2018","journal-title":"Chin Med J."},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.arthro.2006.11.003","article-title":"Radiographic measurements of the intercondylar notch: Are they accurate?","volume":"23","author":"Anderson AF","year":"2007","journal-title":"Arthroscopy."},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"e3439","DOI":"10.1097\/MD.0000000000003439","article-title":"Intercondylar notch stenosis of knee osteoarthritis and relationship between stenosis and osteoarthritis complicated with anterior cruciate ligament injury: A study in MRI","volume":"95","author":"Chen C","year":"2016","journal-title":"Medicine."},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.joca.2009.09.006","article-title":"The relation of femoral notch stenosis to ACL tears in persons with knee osteoarthritis","volume":"18","author":"Stein V","year":"2010","journal-title":"Osteoarthritis Cartilage."},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"051001","DOI":"10.1088\/1741-2552\/ab260c","article-title":"Deep learning\u2010based electroencephalography analysis: A systematic review","volume":"16","author":"Roy Y","year":"2019","journal-title":"J Neural Eng."},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1177\/0363546520959619","article-title":"Anterior cruciate ligament injury incidence in adolescent athletes: A systematic review and meta\u2010analysis","volume":"49","author":"Bram JT","year":"2021","journal-title":"Am J Sports Med."},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"e1437","DOI":"10.1542\/peds.2014-0623","article-title":"Council on sports medicine and fitness, and section on orthopaedics. 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