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矢状面膝关节的解剖学差异与前交叉韧带损伤相关:来自韩国骨骼未成熟人群的研究结果。

Anatomic Differences in the Sagittal Knee Joint Are Associated With ACL Injury: Results From a Skeletally Immature Korean Population.

作者信息

Kwak Yoon Hae, Nam Ji-Hoon, Koh Yong-Gon, Park Byoung-Kyu, Kang Kyoung-Tak

机构信息

Department of Orthopaedic Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea.

Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea.

出版信息

Orthop J Sports Med. 2021 Apr 5;9(4):2325967121994795. doi: 10.1177/2325967121994795. eCollection 2021 Apr.

Abstract

BACKGROUND

Differences in tibiofemoral articular morphology are associated with risks of anterior cruciate ligament (ACL) injury.

PURPOSE

To determine whether bony and cartilaginous morphological characteristics are related to ACL injury in pediatric patients and to investigate any differences according to sex.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

A total of 200 skeletally immature Korean patients from a single institution were included in this study; 100 patients had an ACL injury, and 100 had an intact ACL. Condylar morphology and tibial slopes were evaluated and compared between the groups, and differences between sexes were evaluated in the ACL-injured group.

RESULTS

The lateral femoral curvature was significantly greater and the lateral and medial tibial curvatures were significantly smaller in the ACL-injured group than in the intact group ( < .01 for all). In addition, the lateral and medial femoral curvatures as well as the lateral tibial curvature were significantly smaller in female than in male patients ( < .01 for all). Both the medial and lateral tibial slopes were greater in the ACL-injured versus intact group (medial slope, 5.5° vs 5.0°; lateral slope, 3.0° vs 1.3°, respectively); this difference was statistically significant for lateral tibial slope ( = .026). No sex-based differences were found for medial or lateral tibial slope.

CONCLUSION

Femoral and tibial curvatures as well as lateral tibial slope were significantly different between the ACL-injured and ACL-intact patients, and the lateral tibial curvature was significantly smaller in female than in male patients. Medial and lateral tibial slopes were not associated with a significant difference in ACL injury between male and female patients.

摘要

背景

胫股关节形态差异与前交叉韧带(ACL)损伤风险相关。

目的

确定骨骼和软骨形态特征是否与小儿患者的ACL损伤有关,并研究性别差异。

研究设计

队列研究;证据等级,3级。

方法

本研究纳入了来自单一机构的200例骨骼未成熟的韩国患者;100例患者发生ACL损伤,100例患者ACL完整。评估并比较两组间的髁形态和胫骨坡度,并在ACL损伤组中评估性别差异。

结果

ACL损伤组的外侧股骨曲率显著大于ACL完整组,外侧和内侧胫骨曲率显著小于ACL完整组(均P<0.01)。此外,女性患者的外侧和内侧股骨曲率以及外侧胫骨曲率均显著小于男性患者(均P<0.01)。ACL损伤组的内侧和外侧胫骨坡度均大于ACL完整组(内侧坡度分别为5.5°和5.0°;外侧坡度分别为3.0°和1.3°);外侧胫骨坡度差异具有统计学意义(P=0.026)。在内侧或外侧胫骨坡度方面未发现基于性别的差异。

结论

ACL损伤患者与ACL完整患者之间的股骨和胫骨曲率以及外侧胫骨坡度存在显著差异,女性患者的外侧胫骨曲率显著小于男性患者。内侧和外侧胫骨坡度与男性和女性患者ACL损伤的显著差异无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/445e/8024458/13456fb063f6/10.1177_2325967121994795-fig1.jpg

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