Zeng Chao, Yang Tuo, Wu Song, Gao Shu-guang, Li Hui, Deng Zhen-han, Zhang Yi, Lei Guang-hua
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Department of Orthopaedics, Third-Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Knee Surg Sports Traumatol Arthrosc. 2016 Mar;24(3):830-7. doi: 10.1007/s00167-014-3382-x. Epub 2014 Oct 19.
This study aimed to: (1) examine whether the association between posterior tibial slope and noncontact ACL injury exists in Chinese population; (2) compare the reliability and consistency of the three methods (longitudinal axis, posterior and anterior tibial cortex axis) in lateral radiograph.
Case-control study contained 146 patients in total (73 noncontact ACL injuries and 73 meniscus injuries, matched for age and gender), which were verified by arthroscopy, MRI and physical examination.
For the total population and the male subgroup, the mean posterior tibial slope of the ACL-injured group was significantly higher than that of the control group (P < 0.001). In addition, the longitudinal axis method exhibited the highest inter-rater (0.898) and intrarater reliability (0.928), whereas the anterior tibial cortex was the most variable (inter-rater reliability, 0.805; intrarater reliability, 0.824). The anterior tibial cortex method produced largest posterior tibial slope measurements (13.8 ± 3.3 for injury group; 11.6 ± 2.7 for control group), while the posterior tibial cortex method was the smallest (9.1 ± 3.1 for injury group; 7.2 ± 2.6 for control group). All three methods were not affected by age, sex, height, weight and BMI (n.s.).
The results of this study suggested that an increased posterior tibial slope was associated with the risk of noncontact ACL injury in Chinese population. Meanwhile, the longitudinal axis method is recommended for measuring posterior tibial slope in lateral radiograph in future studies. Posterior tibial slope measured by longitudinal axis method may be used as predictor of ACL injury.
Case-control study, Level III.
本研究旨在：（1）检验中国人群中胫骨后倾与非接触性前交叉韧带损伤之间是否存在关联；（2）比较三种方法（纵轴、胫骨后皮质轴和胫骨前皮质轴）在外侧位X线片上测量的可靠性和一致性。
病例对照研究共纳入146例患者（73例非接触性前交叉韧带损伤患者和73例半月板损伤患者，年龄和性别相匹配），所有患者均经关节镜检查、磁共振成像（MRI）和体格检查确诊。
在总体人群和男性亚组中，前交叉韧带损伤组的平均胫骨后倾显著高于对照组（P < 0.001）。此外，纵轴法的组间信度（0.898）和组内信度（0.928）最高，而胫骨前皮质轴法的信度变化最大（组间信度为0.805；组内信度为0.824）。胫骨前皮质轴法测量的胫骨后倾最大（损伤组为13.8 ± 3.3；对照组为11.6 ± 2.7），而胫骨后皮质轴法测量的最小（损伤组为9.1 ± 3.1；对照组为7.2 ± 2.6）。所有三种方法均不受年龄、性别、身高、体重和体重指数（BMI）的影响（无统计学意义）。
本研究结果表明，胫骨后倾增加与中国人群非接触性前交叉韧带损伤风险相关。同时，建议在未来研究中采用纵轴法测量外侧位X线片上的胫骨后倾。通过纵轴法测量的胫骨后倾可作为前交叉韧带损伤的预测指标。
病例对照研究，III级。
