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.
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