Cavaignac Etienne, Wytrykowski Karine, Reina Nicolas, Pailhé Regis, Murgier Jérôme, Faruch Marie, Chiron Philippe
Institut de l'Appareil Locomoteur, Hopital Pierre Paul Riquet, Toulouse, France.
Institut de l'Appareil Locomoteur, Hopital Pierre Paul Riquet, Toulouse, France.
Arthroscopy. 2016 Jan;32(1):120-6. doi: 10.1016/j.arthro.2015.07.015. Epub 2015 Sep 26.
To determine ultrasonography's sensitivity for identifying the anterolateral ligament (ALL).
A descriptive study of 18 cadaveric knees was performed. Ultrasonography was used to locate any anterolateral structures at the knee that could correspond to the ALL. The structure's length and relation with other notable anatomic landmarks (fibular head, Gerdy tubercle, joint line, lateral femoral epicondyle, popliteus tendon insertion) were quantified. The ultrasonography measurements were validated by dissecting each knee. The sensitivity of ultrasonography for detecting the ALL and the agreement between the ultrasonographic and cadaveric measurements (Cohen κ) were determined by statistical analysis.
The ALL was found in all 18 cadaveric knees and corresponded anatomically to the ultrasonographic descriptions. Ultrasonography had 100% sensitivity for detecting the presence of the ALL. The ALL's insertion on the lateral femoral condyle was, on average, 12.08 mm (SD, 4 mm; range, 7 to 15 mm) proximal and posterior to the lateral femoral epicondyle and 20.5 mm (SD, 3 mm; range, 16 to 24 mm) proximal to the middle of the popliteus tendon insertion. The ALL inserted onto the tibia, midway between the Gerdy tubercle and the fibular head; the distance between the midpoint of the tibial insertion and middle of the Gerdy tubercle was 19.05 mm (SD, 2.1 mm; range, 15 to 25 mm), and the distance was 19.13 mm (SD, 2.3 mm; range, 14 to 23 mm) to the tip of the fibular head. The agreement between the ultrasonographic and cadaveric findings was excellent (Cohen κ coefficient between 0.88 and 0.94).
Ultrasound imaging is a suitable tool for identifying the ALL of the knee, and it allowed for a detailed analysis of the entire ALL in all 18 knees. However, its ability to evaluate any injuries to the ALL must still be shown.
Ultrasonography can be used to confirm the integrity of the ALL.
确定超声检查对识别前外侧韧带（ALL）的敏感性。
对18个尸体膝关节进行描述性研究。使用超声检查来定位膝关节处可能与ALL相对应的任何前外侧结构。对该结构的长度以及与其他显著解剖标志（腓骨头、Gerdy结节、关节线、股骨外侧髁、腘肌腱附着点）的关系进行量化。通过解剖每个膝关节来验证超声测量结果。通过统计分析确定超声检查对检测ALL的敏感性以及超声测量与尸体测量之间的一致性（Cohen κ）。
在所有18个尸体膝关节中均发现了ALL，并且在解剖学上与超声描述相符。超声检查检测ALL存在的敏感性为100%。ALL在股骨外侧髁的附着点平均位于股骨外侧髁近端和后方12.08 mm（标准差，4 mm；范围，7至15 mm）处，且位于腘肌腱附着点中点近端20.5 mm（标准差，3 mm；范围，16至24 mm）处。ALL附着于胫骨，位于Gerdy结节和腓骨头之间的中点；胫骨附着点中点与Gerdy结节中点之间的距离为19.05 mm（标准差, 2.1 mm；范围，15至25 mm），与腓骨头尖端的距离为19.13 mm（标准差, 2.3 mm；范围，14至23 mm）。超声检查结果与尸体解剖结果之间的一致性极佳（Cohen κ系数在0.88至0.94之间）。
超声成像是识别膝关节ALL的合适工具，并且它能够对所有18个膝关节中的整个ALL进行详细分析。然而，其评估ALL任何损伤的能力仍有待证明。
超声检查可用于确认ALL的完整性。
