Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Health Management Center, Xiangya Hospital, Central South University, Changsha, China; Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, China.
Arthroscopy. 2018 Mar;34(3):889-900. doi: 10.1016/j.arthro.2017.08.299. Epub 2018 Jan 20.
To explore the association between the magnetic resonance imaging (MRI)-measured intercondylar notch dimensions, including the intercondylar notch width (NW) and intercondylar notch width index (NWI), and the risk of anterior cruciate ligament (ACL) injury by performing a meta-analysis of studies that relied on the multiplanar imaging and soft-tissue visualization strengths of MRI.
The MEDLINE, Embase, and SportDiscus databases were searched from inception to March 2017. Observational studies reporting on the associations of the NWI and NW with ACL injury were retrieved. A random-effects model was used to calculate the overall weighted mean difference (WMD) between the ACL injury group and control group.
A total of 20 studies were included in this meta-analysis. The combined data showed that subjects with ACL injury, as compared with the control group, had a significantly decreased NW (pooled WMD, -1.53 [95% confidence interval, -1.81 to -1.25]; P < .00001) and NWI (pooled WMD, -0.02 [95% confidence interval, -0.03 to -0.01]; P < .00001). Similar findings were observed in subgroup analyses in terms of different injury mechanisms. No significant difference in NWI was found in the axial view. A significantly decreased NW and NWI were found in other plane views. The sensitivity analyses after the exclusion of studies enrolling only athletes or skeletally immature subjects reached similar outcomes. The Begg rank correlation test showed no publication bias.
With the accumulation of evidence, this meta-analysis concluded that the NW and/or NWI measured by MRI was significantly lower in ACL-injured patients than in control subjects. For persons with a narrow intercondylar notch, preventive measures can be prepared for the prevention of ACL injuries.
Level III, meta-analysis of Level II and III studies.
通过对依赖磁共振成像（MRI）多平面成像和软组织可视化优势进行研究的荟萃分析，探讨 MRI 测量的髁间切迹尺寸（包括髁间切迹宽度（NW）和髁间切迹宽度指数（NWI））与前交叉韧带（ACL）损伤风险之间的关系。
从建库到 2017 年 3 月，检索 MEDLINE、Embase 和 SportDiscus 数据库，检索关于 NWI 和 NW 与 ACL 损伤相关性的观察性研究。使用随机效应模型计算 ACL 损伤组与对照组之间的总体加权均数差值（WMD）。
共有 20 项研究纳入本荟萃分析。综合数据显示，与对照组相比，ACL 损伤组的 NW（合并 WMD，-1.53 [95%置信区间，-1.81 至-1.25]；P <.00001）和 NWI（合并 WMD，-0.02 [95%置信区间，-0.03 至-0.01]；P <.00001）明显减小。根据不同损伤机制的亚组分析也观察到类似的结果。在轴位视图中，NWI 无显著差异。在其他平面视图中，NW 和 NWI 明显减小。排除仅纳入运动员或骨骼未成熟受试者的研究后进行敏感性分析，得出的结果相似。Begg 秩相关检验未显示发表偏倚。
随着证据的积累，本荟萃分析得出结论，MRI 测量的 NW 和/或 NWI 在 ACL 损伤患者中明显低于对照组。对于髁间切迹较窄的人，可以为预防 ACL 损伤做好预防措施。
III 级，II 级和 III 级研究的荟萃分析。
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