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在前交叉韧带断裂的患者中,胫骨股骨骨挫伤的体积与半月板损伤和膝关节松弛无关。

Tibiofemoral bone bruise volume is not associated with meniscal injury and knee laxity in patients with anterior cruciate ligament rupture.

机构信息

Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal.

Dom Henrique Research Centre, Porto, Portugal.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2019 Oct;27(10):3318-3326. doi: 10.1007/s00167-018-5343-2. Epub 2019 Jan 2.

Abstract

PURPOSE

This study aimed at evaluating the association between the volume of the bone bruises and the magnitude of knee sagittal laxity and presence of meniscal injury in patients with anterior cruciate ligament (ACL) rupture. It was hypothesized that higher volumes of bone bruises will be associated with increased knee laxity and the presence of meniscal injury.

METHODS

Patients with clinical diagnosis of ACL injury were referred for magnetic resonance imaging (MRI) and knee sagittal laxity measurement with a mechanical instrumented device (Porto-Knee Testing Device). The femoral and tibial bone bruises were assessed by MRI and the volume measured by manually contouring the bone bruise using a computerized software and computed by a mathematical algorithm combining all measured areas. The ACL rupture type (partial or total), meniscal tear (medial or lateral), and the localization of bone bruise were also analyzed.

RESULTS

Seventy-six ACL-ruptured participants were included and 34 patients displayed bone bruises. Tibiofemoral sagittal laxity was higher in participants with complete ACL rupture (p < 0.05), but not influenced by the volume of bone bruises and meniscal status (n.s.). The volume of bone bruises was not significantly associated with the meniscal lesion or with the tibiofemoral sagittal laxity, independently of the meniscal injury status (n.s.).

CONCLUSIONS

The volume of femoral and/or tibial bone bruises was not associated with the type of ACL injury, tibiofemoral sagittal laxity or the status of meniscal injury. Bone bruises must be considered as a radiographic sign of injury and should not be suggestive of injury severity and not overvalued.

LEVEL OF EVIDENCE

Retrospective cohort study, Level III.

IRB NUMBER

0011/0014.

摘要

目的

本研究旨在评估前交叉韧带(ACL)断裂患者的骨瘀伤体积与膝关节矢状面松弛度和半月板损伤程度之间的关系。假设骨瘀伤体积越大,膝关节松弛度越大,半月板损伤的可能性越大。

方法

临床诊断为 ACL 损伤的患者被转诊进行磁共振成像(MRI)和机械仪器设备(Porto-Knee 测试设备)测量膝关节矢状面松弛度。通过 MRI 评估股骨和胫骨骨瘀伤,并使用计算机软件手动勾勒骨瘀伤轮廓,通过组合所有测量区域的数学算法计算其体积。还分析 ACL 断裂类型(部分或完全)、半月板撕裂(内侧或外侧)和骨瘀伤的定位。

结果

共纳入 76 名 ACL 断裂患者,其中 34 名患者出现骨瘀伤。完全 ACL 断裂患者的胫股矢状面松弛度较高(p < 0.05),但不受骨瘀伤体积和半月板状态的影响(n.s.)。骨瘀伤体积与半月板损伤或胫股矢状面松弛度无显著相关性,与半月板损伤状态无关(n.s.)。

结论

股骨和/或胫骨骨瘀伤的体积与 ACL 损伤类型、胫股矢状面松弛度或半月板损伤状态无关。骨瘀伤应被视为损伤的影像学征象,不应提示损伤严重程度,也不应高估其价值。

证据水平

回顾性队列研究,III 级。

IRB 编号:0011/0014。

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