外侧股骨髁比与非接触性前交叉韧带损伤中 ALC 损伤的风险增加相关。
Increased lateral femoral condyle ratio is associated with greater risk of ALC injury in non-contact anterior cruciate ligament injury.
机构信息
Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Division of Rheumatology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2021 Sep;29(9):3077-3084. doi: 10.1007/s00167-020-06347-0. Epub 2020 Nov 10.
PURPOSE
To examine whether increased lateral femoral condyle ratio (LFCR) correlates with increased risk of Anterior cruciate ligament (ACL) injury (1) and to evaluate the relationship between the LFCR and anterolateral complex (ALC) injury in non-contact ACL torn knees (2).
METHODS
Six hundred and seventy-two patients who underwent ACL reconstruction surgery between 2013 and 2019 were retrospectively reviewed, and 120 patients were finally included in the study. Forty patients (ACL + ALC injury) were included in the study group, while forty patients with isolated ACL injury (isolated ACL injury group) and 40 patients who suffered from meniscal tear without ACL or ALC injury were matched in a 1:1 fashion by age, sex, and BMI to the study group (ACL + ALC injury). The LFCR was measured on standard lateral radiographs in a blinded fashion. The differences between the three groups were analyzed by ANOVA. A ROC (Receiver Operating Characteristic) curve was produced to determine risk of ACL injury and risk of concomitant ALC injury in non-contact ACL injury.
RESULTS
The mean LFCR was 71.9% ± 3.1% in the ACL + ALC injury group, 68.4% ± 3.2% in the isolated ACL injury group, and 66.8% ± 2.6% in the control group (patients who suffered from meniscal tear without ACL or ALC injury). Significantly greater LFCR was found in the ACL + ALC injury group than that in the isolated ACL injury group (p < 0.017). Greater LFCR was additionally confirmed in the ACL injury group as compared to the control group (p < 0.05). ROC curve analysis demonstrated that LFCR > 68.3% was predictive for an increased risk of ACL injury in the entire cohort. LFCR > 69.4% was predictive for an increased risk of ALC injury in non-contact ACL ruptured patients.
CONCLUSION
Increased LFCR was found to be associated with greater risk of ALC injury in non-contact ACL ruptured patients. Additionally, increased LFCR was further confirmed to be correlated with increased risk of ACL injury in an Asian population. The data from this study may help recognize patients undergoing ACL reconstruction that could benefit from additional extra-articular tenodesis.
LEVEL OF EVIDENCE
III.
目的
探讨外侧股骨髁比（LFCR）增加是否与前交叉韧带（ACL）损伤的风险增加相关（1），并评估非接触性 ACL 撕裂膝关节中 LFCR 与前外侧复合体（ALC）损伤的关系（2）。
方法
回顾性分析 2013 年至 2019 年间接受 ACL 重建手术的 672 例患者，最终纳入 120 例患者进行研究。40 例（ACL+ALC 损伤）患者纳入研究组，同时按年龄、性别和 BMI 与研究组（ACL+ALC 损伤）1:1 配对纳入 40 例单纯 ACL 损伤（单纯 ACL 损伤组）和 40 例半月板撕裂无 ACL 或 ALC 损伤的患者。在盲法下测量标准侧位 X 线片上的 LFCR。通过 ANOVA 分析三组之间的差异。绘制 ROC（Receiver Operating Characteristic）曲线以确定非接触性 ACL 损伤中 ACL 损伤的风险和同时发生 ALC 损伤的风险。
结果
ACL+ALC 损伤组的平均 LFCR 为 71.9%±3.1%，单纯 ACL 损伤组为 68.4%±3.2%，对照组（半月板撕裂无 ACL 或 ALC 损伤）为 66.8%±2.6%。ACL+ALC 损伤组的 LFCR 明显大于单纯 ACL 损伤组（p<0.017）。与对照组相比，ACL 损伤组的 LFCR 也更高（p<0.05）。ROC 曲线分析表明，LFCR>68.3%可预测整个队列中 ACL 损伤风险增加。LFCR>69.4%可预测非接触性 ACL 断裂患者 ALC 损伤风险增加。
结论
在非接触性 ACL 断裂患者中，发现 LFCR 增加与 ALC 损伤风险增加相关。此外，在亚洲人群中，进一步证实 LFCR 增加与 ACL 损伤风险增加相关。本研究的数据可能有助于识别接受 ACL 重建的患者，这些患者可能受益于额外的关节外肌腱固定术。
证据水平
III。
Zotero 插件