Takahashi Tsuneari, Kimura Masashi, Takeshita Katsushi
1 Gunma Sports Medicine Research Center, Zenshukai Hospital, Maebashi, Japan.
2 Department of Orthopaedic Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan.
J Orthop Surg (Hong Kong). 2017 Sep-Dec;25(3):2309499017739479. doi: 10.1177/2309499017739479.
To clarify the relationship between anterior cruciate ligament (ACL) remnant tissue at the time of surgery and preoperative evaluation of ACL-injured knee.
A total of 123 patients were enrolled and classified into four groups based on the classification of ACL remnant tissue. To quantify the signal-noise quotient (SNQ), five regions of interest (ROIs), such as tibial, mid, femoral ACL remnant, tendon of quadriceps femoris to normalize the signal intensity of ACL remnant tissue, and background measurements, were measured. Preoperative side-to-side difference (SSD) and SNQ were analyzed.
Significant differences were observed in preoperative SSD of the four groups ( p = 0.021), and a post hoc analysis revealed that SSD in Crain type 2 was significantly smaller than that in Crain type 4 ( p = 0.014). SSD in Crain type 3 was also significantly smaller than that in Crain type 4 ( p = 0.0030). There were significant differences in SNQ at the tibial, mid, and femoral portion in Crain types 2 and 3 ( p < 0.001); SNQ at the tibial portion in Crain type 2 was significantly lower than that at the mid portion ( p = 0.024); and SNQ at the tibial portion in Crain type 3 was significantly lower than that at the mid portion ( p = 0.016). Furthermore, significant differences were observed in SNQ at the tibial portions in the four groups ( p = 0.034), and SNQ at the tibial portions in Crain type 2 was significantly lower than that in Crain type 1 ( p = 0.044). Also, SNQ at the tibial portions in Crain type 3 was significantly lower than that in Crain type 1 ( P = 0.035).
The femoral attachment of the ACL remnant tissue may influence the SNQ of the tibial remnant tissue and the stability of the ACL-injured knee.
阐明手术时前交叉韧带（ACL）残余组织与ACL损伤膝关节术前评估之间的关系。
共纳入123例患者，根据ACL残余组织的分类分为四组。为了量化信号噪声商（SNQ），测量了五个感兴趣区域（ROI），如胫骨、中部、股骨ACL残余、股四头肌肌腱以标准化ACL残余组织的信号强度以及背景测量值。分析术前双侧差异（SSD）和SNQ。
四组术前SSD存在显著差异（p = 0.021），事后分析显示，Crain 2型的SSD显著小于Crain 4型（p = 0.014）。Crain 3型的SSD也显著小于Crain 4型（p = 0.0030）。Crain 2型和3型在胫骨、中部和股骨部分的SNQ存在显著差异（p < 0.001）；Crain 2型胫骨部分的SNQ显著低于中部（p = 0.024）；Crain 3型胫骨部分的SNQ显著低于中部（p = 0.016）。此外，四组在胫骨部分的SNQ存在显著差异（p = 0.034），Crain 2型胫骨部分的SNQ显著低于Crain 1型（p = 0.044）。同样，Crain 3型胫骨部分的SNQ显著低于Crain 1型（P = 0.035）。
ACL残余组织的股骨附着可能影响胫骨残余组织的SNQ和ACL损伤膝关节的稳定性。
