亚急性和慢性前交叉韧带损伤患者关节线压痛与半月板病变的相关性

Correlation of joint line tenderness and meniscus pathology in patients with subacute and chronic anterior cruciate ligament injuries.

作者信息

Shelbourne K Donald, Benner Rodney W

机构信息

Shelbourne Knee Center at Methodist Hospital, 1815 N Capitol Ave, Suite 530, Indianapolis, IN 46202, USA.

出版信息

J Knee Surg. 2009 Jul;22(3):187-90. doi: 10.1055/s-0030-1247747.

DOI:10.1055/s-0030-1247747

PMID:19634720

Abstract

We evaluated joint line tenderness (JLT) as a test for meniscus pathology in 3531 patients who underwent anterior cruciate ligament (ACL) reconstruction >30 days postinjury. If the patient had no additional giving-way episode after the index ACL injury, the injury was considered subacute; otherwise, it was considered chronic. Immediately before surgery, the presence or absence of medial or lateral JLT was evaluated. During ACL reconstruction, the presence or absence of meniscal tears was documented. In the subacute population, JLT was 41% sensitive, 56% specific, and 50% accurate for detecting medial meniscal tears and 57% sensitive, 44% specific, and 49% accurate for detecting lateral meniscal tears. In the chronic population, JLT was 55% sensitive, 50% specific, and 52% accurate for detecting medial meniscal tears and 46% sensitive, 52% specific, and 50% accurate for detecting lateral meniscal tears. The presence of JLT alone should not be used in the clinical decision making process to guide treatment.

摘要

我们对3531例受伤超过30天接受前交叉韧带（ACL）重建的患者进行了评估，将关节线压痛（JLT）作为半月板病变的一项检测指标。如果患者在初次ACL损伤后没有再次出现打软腿情况，则该损伤被视为亚急性损伤；否则，被视为慢性损伤。在手术前即刻，评估患者是否存在内侧或外侧JLT。在ACL重建过程中，记录半月板撕裂情况。在亚急性人群中，JLT检测内侧半月板撕裂的敏感度为41%、特异度为56%、准确度为50%，检测外侧半月板撕裂的敏感度为57%、特异度为44%、准确度为49%。在慢性人群中，JLT检测内侧半月板撕裂的敏感度为55%、特异度为50%、准确度为52%，检测外侧半月板撕裂的敏感度为46%、特异度为52%、准确度为50%。单独JLT的存在不应在临床决策过程中用于指导治疗。