Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey.
Orthopedics and Traumatology Clinic, Kahramankazan State Hospital, Ankara, Turkey.
J Knee Surg. 2021 Apr;34(5):570-580. doi: 10.1055/s-0040-1713814. Epub 2020 Jul 13.
The purpose of this study was to identify the anatomical risk factors and determine the role of meniscal morphology in noncontact anterior cruciate ligament (ACL) rupture. A total of 126 patients (63 with noncontact ACL rupture and 63 age- and sex-matched controls) with intact menisci were included in this retrospective case-control study. On knee magnetic resonance imaging (MRI), meniscal morphometry (anterior, corpus, and posterior heights and widths of each meniscus), tibial slope (medial and lateral separately), notch width index, roof inclination angle, anteromedial bony ridge, tibial eminence area, and Q-angle measurements were assessed. The data were analyzed using multiple regression analyses to identify independent risk factors associated with ACL rupture. Using a univariate analysis, medial and lateral menisci anterior horn heights ( < 0.001; < 0.003), medial and lateral menisci posterior horn heights ( < 0.001; < 0.001), lateral meniscus corpus width ( < 0.004), and notch width index ( < 0.001) were significantly higher in the control group. Lateral tibial slope ( < 0.001) and anteromedial bony ridge thickness ( < 0.001) were significantly higher in the ACL rupture group. Multivariate analysis revealed that decreased medial meniscus posterior horn height (odds ratio [OR]: 0.242; < 0.001), increased lateral meniscus corpus width (OR: 2.118; < 0.002), increased lateral tibial slope (OR: 1.95; < 0.001), and decreased notch width index (OR: 0.071; = 0.046) were independent risk factors for ACL rupture. Notch stenosis, increased lateral tibial slope, decreased medial meniscus posterior horn height, and increased lateral meniscus corpus width are independent anatomical risk factors for ACL rupture. Meniscal morphological variations also play a role in ACL injury. This is a Level III, retrospective case-control study.
本研究旨在确定解剖学危险因素，并确定半月板形态在非接触性前交叉韧带（ACL）断裂中的作用。这项回顾性病例对照研究共纳入 126 例（63 例非接触性 ACL 断裂患者和 63 例年龄和性别匹配的对照组），所有患者的半月板均完整。在膝关节磁共振成像（MRI）上，评估了半月板形态计量学（每个半月板的前角、体部和后角高度和宽度）、胫骨倾斜度（内侧和外侧分别）、切迹宽度指数、顶倾斜角、前内侧骨嵴、胫骨隆突面积和 Q 角测量值。使用多元回归分析来识别与 ACL 断裂相关的独立危险因素。使用单变量分析，内侧和外侧半月板前角高度（ < 0.001； < 0.003）、内侧和外侧半月板后角高度（ < 0.001； < 0.001）、外侧半月板体部宽度（ < 0.004）和切迹宽度指数（ < 0.001）在对照组中显著较高。ACL 断裂组的外侧胫骨倾斜度（ < 0.001）和前内侧骨嵴厚度（ < 0.001）显著较高。多变量分析显示，内侧半月板后角高度降低（比值比[OR]：0.242； < 0.001）、外侧半月板体部宽度增加（OR：2.118； < 0.002）、外侧胫骨倾斜度增加（OR：1.95； < 0.001）和切迹宽度指数降低（OR：0.071； = 0.046）是 ACL 断裂的独立危险因素。切迹狭窄、外侧胫骨倾斜度增加、内侧半月板后角高度降低和外侧半月板体部宽度增加是 ACL 断裂的独立解剖学危险因素。半月板形态学变化也在 ACL 损伤中起作用。这是一项 III 级回顾性病例对照研究。
