与 ACL 断裂相关的半月板损伤的解剖学危险因素。
Anatomic risk factor for meniscal lesion in association with ACL rupture.
机构信息
Department of Orthopaedics, Groupement Hospitalier Nord, Université Lyon 1, 103 Grande rue de la Croix Rousse, 69004, Lyon, France.
Department of Orthopaedics, The Ohio State University, 2050 Kenny Rd #3100, Columbus, OH, 43210, USA.
出版信息
J Orthop Surg Res. 2019 Jul 30;14(1):242. doi: 10.1186/s13018-019-1281-z.
BACKGROUND
To assess anatomic risk factors for meniscal lesions in association with acute ACL rupture. The primary hypothesis was that tibiofemoral anatomic measures will be different in those with and without concomitant meniscus tears.
METHODS
A retrospective review of patients who underwent acute ACL reconstruction in the department was performed. All patients underwent a postoperative CT scan. The concavity and/or convexity on the femur and the tibia were measured by two blinded observers on the sagittal plane with different ratios, and these measures were compared in patients with and without meniscus tears in each compartment. Intra- and inter-rater reliabilities were assessed.
RESULTS
Four hundred twelve patients (268 males and 144 females) were included from October 2012 to February 2015. One hundred sixty-seven patients had a medial meniscal tear (119 males/48 females), and 100 had a lateral meniscal tear (80 males/20 females). The mean time from injury to surgery was 3 months. The average ICC for all measurements was 0.87 (range 0.82-0.98) indicating good reliability. The medial femoral condyle was noted to be significantly longer than the medial tibial plateau in the sagittal plane in patients with a medial meniscal tear (p = 0.04), and the lateral femoral condyle was noted to be significantly longer than the lateral tibial plateau in the sagittal plane in patients with a lateral meniscal tear (p < 0.001). In addition, a less convex lateral tibial plateau was statistically correlated with a higher risk of lateral meniscal tear (p = 0.001).
CONCLUSIONS
A greater anteroposterior length of the medial/lateral femoral condyle relative to the medial/lateral tibial plateau is associated with an increased risk of meniscal lesions in association with acute ACL rupture. The lateral compartment in the male population appears to be the most at risk.
TRIAL REGISTRATION
Retrospectively registered on May 12, 2016 (CPP sud-est II CAL n°2016-037).
背景
评估与急性 ACL 断裂相关的半月板损伤的解剖学危险因素。主要假设是，在伴有和不伴有半月板撕裂的患者中，胫股解剖测量值将有所不同。
方法
对该部门行急性 ACL 重建的患者进行回顾性研究。所有患者均行术后 CT 扫描。两名盲法观察者在矢状面测量股骨和胫骨的凹度和/或凸度，并比较每个间室中伴有和不伴有半月板撕裂的患者的这些测量值。评估了组内和组间的可靠性。
结果
2012 年 10 月至 2015 年 2 月期间，共纳入 412 例患者（268 例男性和 144 例女性）。167 例患者有内侧半月板撕裂（119 例男性/48 例女性），100 例患者有外侧半月板撕裂（80 例男性/20 例女性）。从受伤到手术的平均时间为 3 个月。所有测量值的平均 ICC 为 0.87（范围 0.82-0.98），表明可靠性良好。内侧股骨髁在矢状面中明显长于内侧胫骨平台，在伴有内侧半月板撕裂的患者中（p=0.04），外侧股骨髁在矢状面中明显长于外侧胫骨平台，在伴有外侧半月板撕裂的患者中（p<0.001）。此外，外侧胫骨平台的凸度较小与外侧半月板撕裂的风险增加具有统计学相关性（p=0.001）。
结论
内侧/外侧股骨髁相对于内侧/外侧胫骨平台的前后长度越大，与急性 ACL 断裂相关的半月板损伤风险增加。男性人群中，外侧间室的风险似乎最高。
试验注册
2016 年 5 月 12 日（CPP sud-est II CAL n°2016-037）回顾性注册。
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