Department of Radiology and Orthopedic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-3252, USA.
Radiology. 2012 Aug;264(2):531-41. doi: 10.1148/radiol.12112171. Epub 2012 Jun 12.
To determine the association between osseous injuries and short-term clinical outcome in patients with anterior cruciate ligament (ACL) tear.
The retrospective study was performed with institutional review board approval, and the requirement to obtain informed consent was waived. The study group consisted of 114 patients (57 male and 57 female patients with a mean age of 26.1 and 25.1 years, respectively) with ACL tear who underwent magnetic resonance (MR) imaging and ACL reconstruction surgery and who filled out International Knee Documentation Committee (IKDC) knee evaluation questionnaires before and 1 year after surgery. All MR images were independently reviewed by two radiologists to determine the presence of a cortical depression fracture on each surface of the knee joint. Bone marrow edema volume was quantified by using segmentation software. Correlation coefficients were used to determine the association between bone marrow edema volume and IKDC score. A multivariate analysis model was used to compare IKDC scores in patients without fracture, patients with a single fracture, and patients with multiple fractures.
There was no significant association between total bone marrow edema volume and preoperative or postoperative IKDC score (P = .32 and P = .91, respectively). The mean preoperative and postoperative IKDC scores were 53.4 ± 18.6 and 93.0 ± 5.0, respectively, for patients without fracture, 54.8 ± 13.6 and 87.3 ± 10.8 for patients with a single fracture, and 53.1 ± 17.2 and 83.4 ± 12.7 for patients with multiple fractures. Patients with single and multiple fractures had similar (P = .91) preoperative IKDC scores but significantly lower (P < .001) postoperative IKDC scores compared to patients without fracture.
Cortical depression fractures in patients with ACL tear are associated with decreased clinical outcome scores 1 year after ACL reconstruction surgery.
确定前交叉韧带（ACL）撕裂患者的骨损伤与短期临床结果之间的关系。
这项回顾性研究获得了机构审查委员会的批准，并且豁免了获得知情同意的要求。研究组包括 114 名（57 名男性和 57 名女性，平均年龄分别为 26.1 岁和 25.1 岁）ACL 撕裂患者，他们接受了 MRI 和 ACL 重建手术，并在手术前和手术后 1 年填写了国际膝关节文献委员会（IKDC）膝关节评估问卷。所有 MRI 图像均由两位放射科医生独立进行审查，以确定膝关节各表面是否存在皮质凹陷骨折。使用分割软件量化骨髓水肿体积。使用相关系数确定骨髓水肿体积与 IKDC 评分之间的关系。使用多变量分析模型比较无骨折、单骨折和多骨折患者的 IKDC 评分。
总骨髓水肿体积与术前或术后 IKDC 评分均无显著相关性（P =.32 和 P =.91）。无骨折患者的术前和术后平均 IKDC 评分为 53.4 ± 18.6 和 93.0 ± 5.0，单骨折患者为 54.8 ± 13.6 和 87.3 ± 10.8，多骨折患者为 53.1 ± 17.2 和 83.4 ± 12.7。单骨折和多骨折患者的术前 IKDC 评分相似（P =.91），但术后 IKDC 评分明显低于无骨折患者（P <.001）。
ACL 撕裂患者的皮质凹陷骨折与 ACL 重建手术后 1 年的临床结果评分降低有关。
