Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
J Bone Joint Surg Am. 2016 Jun 15;98(12):1001-6. doi: 10.2106/JBJS.15.01163.
There are conflicting reports regarding the role of osseous morphologic characteristics such as an increased tibial slope as associated with an anterior cruciate ligament (ACL) injury. Few studies have analyzed the role of a combination of osseous morphologic characteristics in matched case control studies. The aim of this study was to determine if there is an association between osseous morphologic characteristics and ACL injury in male college American-football players.
Ninety male U.S. National Collegiate Athletic Association (NCAA) Division-I college football players who underwent magnetic resonance imaging (MRI) for a knee injury between 2005 and 2014 were included. Subjects with an ACL injury (ACL-injured group) were matched for age, height, weight, and body mass index to subjects without an ACL injury (control group). Several osseous morphologic characteristics including medial and lateral condylar width, medial and lateral plateau width, notch width, bicondylar width, notch width index, and medial and lateral tibial slopes were measured and were compared between groups. Conditional logistic regression was used to analyze the data. Significance was set at p < 0.05.
According to univariable analysis, a narrower lateral femoral condyle (odds ratio, 0.82 [95% confidence interval (95% CI), 0.68 to 0.97]), increased medial tibial plateau slope (odds ratio, 1.42 [95% CI, 1.09 to 1.85]), and increased lateral tibial plateau slope (odds ratio, 1.43 [95% CI, 1.15 to 1.78]) were significantly associated with ACL injury. Multivariable analysis revealed that increased lateral tibial slope (odds ratio, 1.32 [95% CI, 1.03 to 1.70]) was the sole independent predictor of ACL injury.
Based on this study, osseous morphology, specifically increased lateral tibial slope, is associated with ACL injury in male college football players. These data might help to improve prevention strategies to lower ACL injury.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
关于胫骨斜率增加等骨性形态特征与前交叉韧带（ACL）损伤的关系，存在相互矛盾的报道。很少有研究分析骨性形态特征的组合在匹配病例对照研究中的作用。本研究旨在确定在男性大学生美式足球运动员中，骨性形态特征与 ACL 损伤之间是否存在关联。
纳入 2005 年至 2014 年间因膝关节损伤接受磁共振成像（MRI）检查的 90 名美国大学生体育协会（NCAA）一级大学美式足球运动员。将 ACL 损伤患者（ACL 损伤组）与无 ACL 损伤患者（对照组）按年龄、身高、体重和体重指数匹配。测量了内侧和外侧髁宽度、内侧和外侧平台宽度、切迹宽度、双髁宽度、切迹宽度指数以及内侧和外侧胫骨斜率等几种骨性形态特征，并对两组进行比较。采用条件逻辑回归分析数据。显著性水平设为 p < 0.05。
根据单变量分析，外侧股骨髁较窄（比值比，0.82 [95%置信区间（95%CI），0.68 至 0.97]）、内侧胫骨平台斜率增加（比值比，1.42 [95%CI，1.09 至 1.85]）和外侧胫骨平台斜率增加（比值比，1.43 [95%CI，1.15 至 1.78]）与 ACL 损伤显著相关。多变量分析显示，外侧胫骨斜率增加（比值比，1.32 [95%CI，1.03 至 1.70]）是 ACL 损伤的唯一独立预测因素。
基于本研究，骨性形态，特别是外侧胫骨斜率增加，与男性大学生足球运动员的 ACL 损伤有关。这些数据可能有助于改善降低 ACL 损伤的预防策略。
预后 III 级。有关证据水平的完整描述，请参见作者说明。
