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基于磁共振成像的急性前交叉韧带损伤膝关节中外侧副韧带异常及相关损伤的患病率

Magnetic Resonance Imaging-Based Prevalence of Anterolateral Ligament Abnormalities and Associated Injuries in Knees with Acute Anterior Cruciate Ligament Injury.

作者信息

Song Yoonah, Yang Jae-Hyuk, Choi Won Rak, Lee Jin Kyu

机构信息

Department of Radiology, Hanyang University Seoul Hospital, Seongdong-gu, Seoul, Republic of Korea.

Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Gyeonggi-do, Republic of Korea.

出版信息

J Knee Surg. 2019 Sep;32(9):866-871. doi: 10.1055/s-0038-1669449. Epub 2018 Sep 6.

Abstract

The purpose of this study was to determine and compare the prevalence of anterolateral ligament abnormality and associated injuries among patients with complete and partial anterior cruciate ligament tears. In addition, the prevalence of associated injuries with anterolateral ligament abnormality was further analyzed. Of the 158 patients diagnosed with acute anterior cruciate ligament tear, 82 patients were diagnosed with acute complete anterior cruciate ligament confirmed by magnetic resonance imaging (MRI) and arthroscopic procedures (Group C), and 74 patients were diagnosed with acute partial anterior cruciate ligament tears confirmed by MRI (Group P). The status of the anterolateral ligament, collateral ligaments, menisci, and osseous lesions was assessed. There was a significantly higher prevalence of anterolateral ligament abnormalities in Group C than Group P (36.6 vs. 4.1%,  < 0.001). Medial collateral ligament, lateral collateral ligament, Segond fracture, osseous lesion at the fibular head, lateral tibial plateau, lateral femoral condyle, and medial tibial plateau were significantly associated with anterolateral ligament abnormality. Furthermore, severity of osseous lesion at the lateral tibial plateau, lateral femoral condyle, and medial tibial plateau was significantly associated (with linear correlation) with anterolateral ligament abnormality. The prevalence of anterolateral ligament abnormality was significantly higher in patients with complete anterior cruciate ligament tear (36.6%) than those with partial anterior cruciate ligament tear (4.1%), but with noticeable prevalence of anterolateral ligament abnormality in the partial anterior cruciate ligament tear group. Associated lesions significant to anterolateral ligament abnormality were tears in both collateral ligaments, lateral-sided osseous lesions, and osseous lesion of the medial tibial plateau.

摘要

本研究的目的是确定并比较完全性和部分性前交叉韧带撕裂患者中外侧副韧带异常及相关损伤的发生率。此外,还进一步分析了与外侧副韧带异常相关的损伤发生率。在158例诊断为急性前交叉韧带撕裂的患者中,82例经磁共振成像(MRI)和关节镜检查确诊为急性完全性前交叉韧带撕裂(C组),74例经MRI确诊为急性部分性前交叉韧带撕裂(P组)。评估了外侧副韧带、侧副韧带、半月板和骨损伤的情况。C组外侧副韧带异常的发生率显著高于P组(36.6%对4.1%,<0.001)。内侧副韧带、外侧副韧带、Segond骨折、腓骨头、胫骨外侧平台、股骨外侧髁和胫骨内侧平台的骨损伤与外侧副韧带异常显著相关。此外,胫骨外侧平台、股骨外侧髁和胫骨内侧平台的骨损伤严重程度与外侧副韧带异常显著相关(呈线性相关)。完全性前交叉韧带撕裂患者中外侧副韧带异常的发生率显著高于部分性前交叉韧带撕裂患者(36.6%对4.1%),但部分性前交叉韧带撕裂组中外侧副韧带异常的发生率也较为显著。与外侧副韧带异常显著相关的合并损伤是双侧副韧带撕裂、外侧骨损伤和胫骨内侧平台骨损伤。

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