Eggerding V, van Kuijk K S R, van Meer B L, Bierma-Zeinstra S M A, van Arkel E R A, Reijman M, Waarsing J H, Meuffels D E
Erasmus Medical Centre, PO box 2040, 3000 CA Rotterdam, the Netherlands.
Erasmus MC University Medical Centre, Department of Orthopaedic surgery, Rotterdam, the Netherlands.
Bone Joint J. 2014 Jun;96-B(6):737-42. doi: 10.1302/0301-620X.96B6.32975.
We have investigated whether shape of the knee can predict the clinical outcome of patients after an anterior cruciate ligament rupture. We used statistical shape modelling to measure the shape of the knee joint of 182 prospectively followed patients on lateral and Rosenberg view radiographs of the knee after a rupture of the anterior cruciate ligament. Subsequently, we associated knee shape with the International Knee Documentation Committee subjective score at two years follow-up. The mean age of patients was 31 years (21 to 51), the majority were male (n = 121) and treated operatively (n = 135). We found two modes (shape variations) that were significantly associated with the subjective score at two years: one for the operatively treated group (p = 0.002) and one for the non-operatively treated group (p = 0.003). Operatively treated patients who had higher subjective scores had a smaller intercondylar notch and a smaller width of the intercondylar eminence. Non-operatively treated patients who scored higher on the subjective score had a more pyramidal intercondylar notch as opposed to one that was more dome-shaped. We conclude that the shape of the femoral notch and the intercondylar eminence is predictive of clinical outcome two years after a rupture of the anterior cruciate ligament.
我们研究了膝关节的形态是否能够预测前交叉韧带断裂患者的临床预后。我们采用统计形状建模方法，对182例接受前瞻性随访的患者在其前交叉韧带断裂后膝关节的外侧位和Rosenberg位X线片上的膝关节形态进行测量。随后，我们将膝关节形态与两年随访时的国际膝关节文献委员会主观评分进行关联。患者的平均年龄为31岁（21至51岁），大多数为男性（n = 121）且接受了手术治疗（n = 135）。我们发现两种模式（形状变异）与两年时的主观评分显著相关：一种针对手术治疗组（p = 0.002），另一种针对非手术治疗组（p = 0.003）。主观评分较高的手术治疗患者髁间切迹较小且髁间隆起宽度较小。主观评分较高的非手术治疗患者髁间切迹呈更尖的金字塔形，而非更圆顶的形状。我们得出结论，股骨切迹和髁间隆起的形态可预测前交叉韧带断裂两年后的临床预后。
