Grassi Alberto, Signorelli Cecilia, Urrizola Francisco, Raggi Federico, Macchiarola Luca, Bonanzinga Tommaso, Zaffagnini Stefano
IRCCS Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Bologna, Italy; IRCSS Istituto Ortopedico Rizzoli, Clinica Ortopedica e Traumatologica II, Bologna, Italy; Università di Bologna, Dipartimento Scienze Biomediche e Neuromotorie - DIBINEM, Bologna, Italy; Humanitas Clinical and Research Center, Rozzano, Milano, Italy.
IRCCS Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Bologna, Italy.
Knee. 2018 Aug;25(4):577-587. doi: 10.1016/j.knee.2018.03.017. Epub 2018 May 24.
Until now, there has been a lack of in vivo analysis of the correlation between bony morphological features and laxity values after an anterior cruciate ligament (ACL) injury.
Forty-two patients who underwent ACL-reconstruction were enrolled. Static laxity was evaluated as: antero-posterior displacement and internal-external rotation at 30° and 90° of flexion (AP30, AP90, IE30, IE90) and varus-valgus rotation at 0° and 30° of flexion (VV0, VV30). The pivot-shift (PS) test defined the dynamic laxity. Using magnetic resonance imaging, we evaluated the transepicondylar distance (TE), the width of the lateral and medial femoral condyles (LFCw and MFCw) and tibial plateau (LTPw and MTPw), the notch width index (NWI) and the ratio of width and height of the femoral notch (N-ratio), the ratio between the height and depth of the lateral and medial femoral condyle (LFC-ratio and MFC-ratio), the lateral and medial posterior tibial slopes (LTPs and MTPs) and the anterior subluxation of the lateral and medial tibial plateau with respect to the femoral condyle (LTPsublx and MTPsublx).
Concerning the AP30, LTPs (P=0.047) and MTPsublx (P=0.039) were shown to be independent predictors while for the AP90 only LTPs (P=0.049) was an independent predictor. The LTPs (P=0.039) was shown to be an independent predictor for IE90 laxity, while for the VV0 test it was identified as the LFCw (P=0.007).
A higher antero-posterior laxity at 30° and 90° of flexion was found in those with a lateral tibial slope <5.5°.
迄今为止，缺乏对前交叉韧带（ACL）损伤后骨形态特征与松弛度值之间相关性的体内分析。
纳入42例行ACL重建的患者。静态松弛度评估如下：在30°和90°屈曲时的前后位移和内外旋转（AP30、AP90、IE30、IE90）以及在0°和30°屈曲时的内翻-外翻旋转（VV0、VV30）。轴移（PS）试验确定动态松弛度。使用磁共振成像，我们评估了髁间距离（TE）、股骨内外侧髁宽度（LFCw和MFCw）以及胫骨平台宽度（LTPw和MTPw）、髁间窝宽度指数（NWI）和股骨髁间窝宽高比（N-ratio）、股骨内外侧髁的高度与深度之比（LFC-ratio和MFC-ratio）、胫骨内外侧后倾角（LTPs和MTPs）以及胫骨内外侧平台相对于股骨髁的前半脱位（LTPsublx和MTPsublx）。
关于AP30，LTPs（P = 0.047）和MTPsublx（P = 0.039）被证明是独立预测因素，而对于AP90，只有LTPs（P = 0.049）是独立预测因素。LTPs（P = 0.039）被证明是IE90松弛度的独立预测因素，而对于VV0试验，其被确定为LFCw（P = 0.007）。
在胫骨外侧斜率<5.5°的患者中，发现30°和90°屈曲时的前后松弛度更高。
