Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19 Suppl 1:S69-76. doi: 10.1007/s00167-011-1524-y. Epub 2011 May 4.
The purpose of this study was to quantify rotational and antero-posterior instabilities using biplanar image-matching technique.
Biplanar radiographs of both chronic ACL-deficient knees and contralateral uninjured knees were taken in the pivot shift test and in the "giving way position" and lateral radiographs in stress arthrometer at 30° and 90°. Three-dimensional knee models were constructed using computed tomography. Using biplanar image-matching technique, the external rotational angle and the translation of the center of the both condyles of the femur were analyzed.
The external rotation angle of geometric center axis in the pivot shift test was 16.9° ± 5.6° and 10.9° ± 7.3° (P = 0.004), and in the "giving way position" was 16.1° ± 5.7° and 10.7° ± 6.6° (P = 0.004) in ACL-deficient knees and intact knees, respectively. In the pivot shift test, the medial and the lateral femoral condylar centers of ACL-deficient knees were translated 1.2 ± 5.1 mm anteriorly and 3.9 ± 3.4 mm posteriorly, respectively, and in the "giving way position," 2.0 ± 3.7 mm anteriorly and 2.9 ± 2.6 mm posteriorly, respectively. In stress arthrometer at 30°, the medial and the lateral femoral condylar center translated 7.1 ± 6.0 and 6.6 ± 4.8 mm posteriorly (n.s.), respectively, and at 90° translated 2.7 ± 3.4 and 2.6 ± 3.5 mm posteriorly (n.s.), respectively.
Rotational instability was evaluable in the pivot shift test and in the "giving way position." Translation of both condylar centers was similar in stress arthrometry. The image-matching technique is able to quantify dynamic rotational and antero-posterior instabilities with static parameters in ACL-deficient knees.
本研究旨在使用双平面图像匹配技术量化旋转和前后不稳定。
在膝关节旋转试验和“失控位”中拍摄双侧慢性 ACL 缺失膝关节和对侧未受伤膝关节的双平面射线照片，并在应力关节造影器中在 30°和 90°拍摄外侧射线照片。使用 CT 构建三维膝关节模型。使用双平面图像匹配技术，分析股骨内外侧髁中心点的外旋角度和移位。
在旋转试验中，几何中心轴的外旋角度在 ACL 缺失膝关节和完整膝关节中分别为 16.9°±5.6°和 10.9°±7.3°（P=0.004），在“失控位”中分别为 16.1°±5.7°和 10.7°±6.6°（P=0.004）。在旋转试验中，ACL 缺失膝关节的内侧和外侧股骨髁中心点分别向前移位 1.2±5.1mm 和向后移位 3.9±3.4mm，在“失控位”中分别向前移位 2.0±3.7mm 和向后移位 2.9±2.6mm。在应力关节造影器 30°时，内侧和外侧股骨髁中心点分别向后移位 7.1±6.0mm 和 6.6±4.8mm（无统计学差异），在 90°时分别向后移位 2.7±3.4mm 和 2.6±3.5mm（无统计学差异）。
在旋转试验和“失控位”中可以评估旋转不稳定。在应力关节造影中，两个髁中心点的移位相似。图像匹配技术能够使用静态参数量化 ACL 缺失膝关节的动态旋转和前后不稳定。
