Park Jin Sung, Nam Dae Chul, Kim Dong Hee, Kim Hyung Kan, Hwang Sun Chul
Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine, Jinju, Korea.
Knee Surg Relat Res. 2012 Sep;24(3):180-5. doi: 10.5792/ksrr.2012.24.3.180. Epub 2012 Sep 3.
The purpose of this study is to find out the differences of distal femur morphology between the anterior cruciate ligament (ACL)-injured and the non-ACL injured on an magnetic resonance imaging (MRI), and the difference of bone structure by gender.
MRI Measurements of notch width (NW), bicondylar width (BCW), medial condyle width (MCW), lateral condyle width (LCW), medial-to-lateral condyle ratio (M:L ratio), and notch entrance width (NE) were taken from 120 subjects with ACL injury and the other 106 subjects without ACL injury, by three independent observers, at two different times. The measured values from MRI figures between the ACL-injured and the non-ACL-injured were compared and analyzed, with consideration of the differences by gender. Both intra and inter-observer reliability were calculated.
There were significant differences of NW, BCW, MCW, LCW and NE by gender (p<0.001). While NW and MCW in male group were different (p<0.001), NW, MCW, M:L ratio and NW index (NWI) in female group were significantly different (p<0.001) in the bone morphology between the ACL-injured and non-ACL-injured. The intra- and inter-observer reliability was satisfying.
If necessary to take an MRI, female patients with small NWI and NW injury should be carefully treated because of possibility of ACL injuries.
本研究旨在通过磁共振成像（MRI）找出前交叉韧带（ACL）损伤患者与非ACL损伤患者之间股骨远端形态的差异，以及不同性别的骨结构差异。
由三名独立观察者在两个不同时间，对120例ACL损伤患者和另外106例非ACL损伤患者进行MRI测量，测量指标包括髁间窝宽度（NW）、双髁宽度（BCW）、内侧髁宽度（MCW）、外侧髁宽度（LCW）、内外侧髁比率（M:L比率）以及髁间窝入口宽度（NE）。比较并分析ACL损伤组与非ACL损伤组MRI图像的测量值，同时考虑性别差异。计算观察者内和观察者间的可靠性。
NW、BCW、MCW、LCW和NE在性别上存在显著差异（p<0.001）。在ACL损伤与非ACL损伤患者的骨形态方面，男性组的NW和MCW存在差异（p<0.001），而女性组的NW、MCW、M:L比率和NW指数（NWI）存在显著差异（p<0.001）。观察者内和观察者间的可靠性令人满意。
如有必要进行MRI检查，NWI较小且NW有损伤的女性患者因有ACL损伤的可能性，应予以谨慎治疗。
