Department of Orthopaedic Surgery, Kamimoku Spa Hospital, Minakami, Japan.
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Knee Surg Sports Traumatol Arthrosc. 2022 Jan;30(1):78-83. doi: 10.1007/s00167-021-06523-w. Epub 2021 Mar 10.
The purpose of this study was to reveal the possible influence of the tibial spine area on the occurrence of ACL injury.
Thirty-nine subjects undergoing anatomical ACL reconstruction (30 female, 9 male: average age 29 ± 15.2) and 37 subjects with intact ACL (21 female, 16 male: average age 29 ± 12.5) were included in this study. In the anterior-posterior (A-P) and lateral knee radiograph, the tibial spine area was measured using a PACS system. In axial knee MRI exhibiting the longest femoral epicondylar length, the intercondylar notch area was measured. Tibial spine area, tibial spine area/body height, and tibial spine area/notch area were compared between the ACL tear and intact groups.
The A-P tibial spine area of the ACL tear and intact groups was 178 ± 34 and 220.7 ± 58mm, respectively. The lateral tibial spine area of the ACL tear and intact groups was 145.7 ± 36.9 and 178.9 ± 41.7mm, respectively. The tibial spine area was significantly larger in the ACL intact group when compared with the ACL tear group (A-P: p = 0.02, lateral: p = 0.03). This trend was unchanged even when the tibial spine area was normalized by body height (A-P: p = 0.01, lateral: p = 0.02). The tibial spine area/notch area of the ACL tear and intact groups showed no significant difference.
The A-P and lateral tibial spine area was significantly smaller in the ACL tear group when compared with the ACL intact group. Although the sample size was limited, a small tibial spine might be a cause of knee instability, which may result in ACL injury.
Level III.
本研究旨在揭示胫骨棘区域对 ACL 损伤发生的可能影响。
本研究纳入了 39 名接受解剖 ACL 重建的受试者（30 名女性，9 名男性；平均年龄 29±15.2 岁）和 37 名 ACL 完整的受试者（21 名女性，16 名男性；平均年龄 29±12.5 岁）。在前后位（A-P）和侧位膝关节 X 线片上，使用 PACS 系统测量胫骨棘区域。在显示最长股骨髁间长度的轴向膝关节 MRI 上，测量髁间切迹区域。比较 ACL 撕裂组和完整组的胫骨棘区域、胫骨棘区域/身高和胫骨棘区域/切迹区域。
ACL 撕裂组和完整组的 A-P 胫骨棘区域分别为 178±34 和 220.7±58mm。ACL 撕裂组和完整组的外侧胫骨棘区域分别为 145.7±36.9 和 178.9±41.7mm。与 ACL 撕裂组相比，ACL 完整组的胫骨棘区域明显更大（A-P：p=0.02，外侧：p=0.03）。即使通过身高对胫骨棘区域进行归一化，这种趋势仍然不变（A-P：p=0.01，外侧：p=0.02）。ACL 撕裂组和完整组的胫骨棘区域/切迹区域无显著差异。
与 ACL 完整组相比，ACL 撕裂组的 A-P 和外侧胫骨棘区域明显更小。尽管样本量有限，但较小的胫骨棘可能是膝关节不稳定的原因，从而导致 ACL 损伤。
III 级。
