Morphological Characteristics of Tibial Eminence and Their Association with Anterior Cruciate Ligament Injury in Patients at a Tertiary Orthopaedic Center in Indonesia
DOI:
https://doi.org/10.37287/ijghr.v8i4.1583Keywords:
anterior cruciate ligament, injury risk factors, knee morphology, radiography, tibial eminenceAbstract
Anterior cruciate ligament (ACL) injury is one of the most common knee ligament injuries, often affecting athletes and active individuals. Morphological variations of the tibial eminence may influence ACL vulnerability. This study aimed to evaluate the relationship between tibial eminence morphology and ACL rupture in an Indonesian patient population. A cross-sectional study was conducted at RSUP Haji Adam Malik, Medan, Indonesia, between 2021 and 2023. Forty-five patients who underwent knee radiographs were enrolled, comprising 25 with ACL rupture and 20 without. Tibial eminence measurements—including medial height, lateral height, and width—were obtained from anteroposterior weight-bearing radiographs. Data were analyzed using Eta correlation, with p<0.05 indicating statistical significance. The ruptured ACL group showed significantly smaller medial height (9.20±1.57 mm), lateral height (8.98±1.55 mm), and width (9.92±2.76 mm) compared to controls (10.42±1.09 mm, 10.16±1.04 mm, and 13.70±2.19 mm, respectively). Eta correlation revealed moderate associations for medial (η=0.411) and lateral heights (η=0.406), and a strong association for width (η=0.607) with ACL rupture. Reduced tibial eminence dimensions, particularly width, are strongly associated with ACL rupture. Radiographic assessment of tibial eminence morphology may assist in risk stratification, especially among high-risk populations.
References
Adhitya, I. P. G. S., Kurniawati, I., Sawa, R., Wijaya, T. F., & Dewi, N. P. A. C. (2023). The risk factors and preventive strategies of poor knee functions and osteoarthritis after anterior cruciate ligament reconstruction: A narrative review. Physical Therapy Research, R0028.
Akcaalan, S., Kavaklilar, A., Caglar, C., Ugurlu, M., & Dogan, M. (2024). Evaluation of the relationship between non-contact anterior cruciate ligament rupture and eminential morphometry: A cross-sectional and MRI based study. BMC Musculoskeletal Disorders, 25(1), 870. https://doi.org/10.1186/s12891-024-07999-6
Babalola, O. R., Igwillo, U. J., Egbekun, I. E., & Oluwadiya, K. S. (2022). Association of Tibia Eminence Width Index and Intercondylar Notch Angle with Risk of Anterior Cruciate Ligament Injury in an African Population. Nigerian Journal of Medicine, 31(3), 323–327. https://doi.org/10.4103/njm.njm_45_22
Barak, M. M. (2024). Cortical and trabecular bone modeling and implications for bone functional adaptation in the mammalian tibia. Bioengineering, 11(5), 514.
Herndon, B. E. (2024). Etiology of the Stenotic Intercondylar Notch: A Clinical Issue Investigated From an Anthropological Perspective. University of California, Riverside.
Hoey, C., Wang, A., Raymond, R. J., Ulagenthiran, A., & Okholm Kryger, K. (2023). Foot morphological variations between different ethnicities and sex: A systematic review. Footwear Science, 15(1), 55–71.
Nakamae, A., Sumen, Y., Tsukisaka, K., Deie, M., Fujimoto, E., Ishikawa, M., Omoto, T., & Adachi, N. (2022). A larger side-to-side difference in anterior knee laxity increases the prevalence of medial and lateral meniscal injuries in patients with ACL injuries. Knee Surgery, Sports Traumatology, Arthroscopy, 30(5), 1560–1567.
Nie, S., Chen, J., Zhang, H., Zhao, P., & Huang, W. (2022). Tibial Spine Height Measured by Radiograph Is a Risk Factor for Non-Contact Anterior Cruciate Ligament Injury in Males: A Retrospective Case-Control Study. International Journal of Environmental Research and Public Health, 19(23), 15589. https://doi.org/10.3390/ijerph192315589
Paudel, Y. R., Sommerfeldt, M., & Voaklander, D. (2023). Increasing incidence of anterior cruciate ligament reconstruction: A 17-year population-based study. Knee Surgery, Sports Traumatology, Arthroscopy, 31(1), 248–255.
Pontoh, L. A. P., Rahyussalim, A. J., Widodo, W., Fiolin, J., & Rhatomy, S. (2021). Anthropometric study as a predictor of anterior cruciate ligament sizes in Asian Indonesian population. Journal of Orthopaedic Surgery, 29(1). https://doi.org/10.1177/23094990211000462
van Kuijk, K. S. R., Eggerding, V., Reijman, M., van Meer, B. L., Bierma-Zeinstra, S. M. A., van Arkel, E., Waarsing, J. H., & Meuffels, D. E. (2021). Differences in knee shape between acl injured and non-injured: A matched case-control study of 168 patients. Journal of Clinical Medicine, 10(5), 1–10. https://doi.org/10.3390/jcm10050968
Zhang, L., Xia, Q., Yang, R., Fan, L., Hu, Y., & Fu, W. (2023). Anatomical factors associated with the development of anterior tibial spine fractures based on MRI measurements. Journal of Orthopaedic Surgery and Research, 18(1), 357. https://doi.org/10.1186/s13018-023-03836-z
Zhang, Q., & Yeh, H. Y. (2021). A comparative study on the tibial morphology among several populations in ancient East Asia. In Elementa (Vol. 9, Issue 1). Science of the Anthropocene, 9(1), 00071. https://doi.org/10.1525/elementa.2021.00071
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
