冰球与其他运动中前交叉韧带损伤后的磁共振成像及关节内表现
Magnetic Resonance Imaging and Intra-articular Findings After Anterior Cruciate Ligament Injuries in Ice Hockey Versus Other Sports.
作者信息
Kluczynski Melissa A, Kang Jeansol V, Marzo John M, Bisson Leslie J
机构信息
University at Buffalo, The State University of New York at Buffalo, Buffalo, New York, USA.
出版信息
Orthop J Sports Med. 2016 May 23;4(5):2325967116646534. doi: 10.1177/2325967116646534. eCollection 2016 May.
BACKGROUND
The prevalence of comorbid knee pathology has been examined for sports-related anterior cruciate ligament (ACL) injuries, but it has not been examined in ice hockey players.
PURPOSE
To compare concomitant bone bruising, collateral ligament injuries, and intra-articular injuries in ACL injuries suffered during ice hockey versus other sports.
STUDY DESIGN
Cross-sectional study; Level of evidence, 3.
METHODS
A total of 20 patients with ACL injuries sustained during ice hockey were identified from a prospective registry, of which 95% were male and 90% had a contact mechanism of injury (MOI). Thirteen cases and 46 controls who sustained ACL injuries from ice hockey and other sports, respectively, were included. Inclusion criteria for cases and controls were male sex, contact MOI, no prior knee surgery, magnetic resonance imaging (MRI) within 6 weeks of injury, and surgery within 3 months of injury. Age, body mass index (BMI), MRI findings (bone bruising, medial and lateral collateral ligament [MCL, LCL] injuries), and arthroscopic findings (meniscus tears, chondral injuries) were compared for cases versus controls using t tests or exact chi-square tests.
RESULTS
Age (22.9 ± 8.8 vs 23.4 ± 10.4 years, P = .88) and BMI ≥25 kg/m(2) (50% vs 65.9%, P = .66) did not differ between cases and controls. Cases had less lateral bone bruising (lateral femoral condyle: 54.6% vs 93%, P = .01; lateral tibial plateau: 72.7% vs 93%, P = .09) and no medial bone bruising (medial femoral condyle: 0% vs 7%, P = .06; medial tibial plateau: 0% vs 32.6%, P = .05) compared with controls. Cases had less frequent lateral meniscus tears than controls (23.1% vs 58.5%, P = .05). There were no significant differences in MCL (40% vs 31.2%, P = .77), LCL (0% vs 3.9%, P > .999), medial meniscus tears (7.7% vs 37%, P = .08), and chondral injuries (10% vs 9.4%, P > .999) for cases versus controls.
CONCLUSION
Male ice hockey players with ACL injuries had less lateral femoral condyle and medial tibial plateau bone bruising compared with other sports injuries. They also had fewer lateral meniscus tears, and there was a trend toward fewer medial meniscus tears. These differences may reflect different MOIs, or the ability to dissipate energy, for contact ACL injuries that occur during ice hockey versus other sports.
背景
已对与运动相关的前交叉韧带（ACL）损伤合并膝关节病变的患病率进行了研究，但尚未在冰球运动员中进行研究。
目的
比较冰球运动中发生的ACL损伤与其他运动中发生的ACL损伤时伴随的骨挫伤、侧副韧带损伤和关节内损伤情况。
研究设计
横断面研究；证据等级为3级。
方法
从一项前瞻性登记研究中确定了20例在冰球运动中发生ACL损伤的患者，其中95%为男性，90%的损伤机制为接触性损伤（MOI）。纳入了分别因冰球运动和其他运动导致ACL损伤的13例病例和46例对照。病例组和对照组的纳入标准为男性、接触性MOI、既往无膝关节手术史、伤后6周内进行磁共振成像（MRI）检查以及伤后3个月内进行手术。使用t检验或确切卡方检验比较病例组和对照组的年龄、体重指数（BMI）、MRI检查结果（骨挫伤、内侧和外侧副韧带[MCL、LCL]损伤）以及关节镜检查结果（半月板撕裂、软骨损伤）。
结果
病例组和对照组的年龄（22.9±8.8岁 vs 23.4±10.4岁，P = 0.88）和BMI≥25 kg/m²（50% vs 65.9%，P = 0.66）无差异。与对照组相比，病例组外侧骨挫伤较少（外侧股骨髁：54.6% vs 93%，P = 0.01；外侧胫骨平台：72.7% vs 93%，P = 0.09），内侧无骨挫伤（内侧股骨髁：0% vs 7%，P = 0.06；内侧胫骨平台：0% vs 32.6%，P = 0.05）。病例组外侧半月板撕裂的发生率低于对照组（23.1% vs 58.5%，P = 0.05）。病例组和对照组在MCL损伤（40% vs 31.2%，P = 0.77）、LCL损伤（0% vs 3.9%，P＞0.999）、内侧半月板撕裂（7.7% vs 37%，P = 0.08）和软骨损伤（10% vs 9.4%，P＞0.999）方面无显著差异。
结论
与其他运动损伤相比，ACL损伤的男性冰球运动员外侧股骨髁和内侧胫骨平台骨挫伤较少。他们的外侧半月板撕裂也较少，内侧半月板撕裂也有减少的趋势。这些差异可能反映了冰球运动与其他运动中发生的接触性ACL损伤的不同损伤机制或能量消散能力。
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