Department of Orthopedics, The Dazu District People'S Hospital, Chongqing, 402360, China.
Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Knee Surg Sports Traumatol Arthrosc. 2020 Mar;28(3):888-896. doi: 10.1007/s00167-019-05541-z. Epub 2019 May 20.
The study purpose is to characterize the sizes of the anterior cruciate ligament (ACL) insertion site and intercondylar notch in Chinese patients undergoing ACL surgery. The findings will provide a reference for individualized clinical treatment of ACL rupture.
For this study, 137 patients (102 males, 35 females) with an average age of 30.3 ± 9.5 years (range 14-52 years) undergoing ACL reconstruction were included. The tibial ACL insertion site length and width and the intercondylar notch width were measured on MRI and arthroscopically using a ruler. Descriptive statistics of the patients, the distribution of the measurements and the differences between males and females were calculated.
The ACL tibial insertion size and intercondylar notch width in Chinese patients with ACL injuries, as obtained by MRI and intra-operatively, exhibited significant individual variability. The tibial ACL insertion site had a mean length of 13.5 ± 2.1 mm and width of 10.9 ± 1.5 mm as measured on MRI and a mean length of 13.3 ± 2.1 mm and width of 11.0 ± 1.6 mm as measured intra-operatively. The mean intercondylar notch width was 15.2 ± 2.4 mm on MRI and the mean length was 15.0 ± 2.5 mm intra-operatively. The inter-rater reliability between MRI and intra-operative measurements confirmed that the two methods were consistent. In 65.7% of individuals, the ACL tibial insertion length was < 14 mm.
The distribution of tibial footprint size in Chinese patients is different from that in Western populations. There is a higher proportion of subjects with a tibial footprint size < 14 mm among Chinese patients with ACL injury. Therefore, great care should be taken when treating this population with the double-bundle technique or larger graft options. Level of evidence IV.
本研究旨在描述接受 ACL 手术的中国患者 ACL 插入部位和髁间切迹的大小。研究结果可为 ACL 撕裂的个体化临床治疗提供参考。
本研究纳入了 137 例（男 102 例，女 35 例）平均年龄 30.3±9.5 岁（14-52 岁）的 ACL 重建患者。使用尺子在 MRI 和关节镜下测量胫骨 ACL 插入部位的长度和宽度以及髁间切迹的宽度。计算患者的描述性统计数据、测量值的分布以及男女之间的差异。
MRI 和术中获得的 ACL 损伤中国患者的 ACL 胫骨插入大小和髁间切迹宽度存在显著的个体差异。胫骨 ACL 插入部位在 MRI 上的平均长度为 13.5±2.1mm，宽度为 10.9±1.5mm，术中平均长度为 13.3±2.1mm，宽度为 11.0±1.6mm。MRI 上的平均髁间切迹宽度为 15.2±2.4mm，术中平均长度为 15.0±2.5mm。MRI 和术中测量的观察者间信度证实两种方法具有一致性。在 65.7%的个体中，ACL 胫骨插入长度<14mm。
中国患者胫骨附着点大小的分布与西方人群不同。ACL 损伤的中国患者中，胫骨附着点大小<14mm 的比例较高。因此，在使用双束技术或较大移植物时，应特别注意治疗该人群。证据等级 IV。
