根据骨挫伤位置和严重程度确定的非接触性前交叉韧带损伤机制。
Mechanisms of non-contact anterior cruciate ligament injury as determined by bone contusion location and severity.
作者信息
Qiu Lanyu, Sheng Bo, Li Jia, Xiao Zhibo, Yuan Mao, Yang Haitao, Lv Fajin, Lv Furong
机构信息
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
出版信息
Quant Imaging Med Surg. 2021 Jul;11(7):3263-3273. doi: 10.21037/qims-20-1212.
BACKGROUND
The location and severity of tibiofemoral bone contusions in magnetic resonance imaging scans in patients with acute non-contact anterior cruciate ligament injuries can reflect the primary mechanisms of anterior cruciate ligament injuries. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the femoral condyle.
METHODS
A retrospective review of 93 consecutive magnetic resonance imaging examinations of patients with acute non-contact anterior cruciate ligament injuries was conducted to identify bone contusions of the knee. The locations and the severity of the bone contusions were determined using magnetic resonance imaging scans for each anatomic site, including the lateral femoral condyle, the lateral tibial plateau, the medial femoral condyle, and the medial tibial plateau. The bone contusions in the lateral-medial and anterior-posterior directions of four anatomical sites were subdivided into six compartments. The severity of the bone contusions was graded on a scale of 1-4. The location and the severity of bone contusions were accessed in the sagittal and coronal planes on the femoral and tibial sides of the knee using the radiology information system.
RESULTS
The prevalence of bone contusions on the magnetic resonance imaging scans was as follows: 78.49% on the lateral femoral condyle, 88.17% on the lateral tibial plateau, 49.46% on the medial femoral condyle, and 69.89% on the medial tibial plateau. The most common and severe compartments of the lateral femoral condyle, the lateral tibial plateau, the medial femoral condyle, and the medial tibial plateau were the central-lateral (CL), the posterior-medial (PM), the CL, and the posterior-lateral (PL) compartments, respectively.
CONCLUSIONS
The location patterns and severity of bone contusions in patients indicated that internal tibial rotation, valgus, and the anterior and lateral translation of the tibia were the primary mechanisms of non-contact anterior cruciate ligament injury.
背景
急性非接触性前交叉韧带损伤患者磁共振成像扫描中胫股骨挫伤的位置和严重程度可反映前交叉韧带损伤的主要机制。在胫骨平台和股骨髁的内侧和外侧方向细分骨挫伤模型的研究有限。
方法
对93例急性非接触性前交叉韧带损伤患者的连续磁共振成像检查进行回顾性分析，以确定膝关节的骨挫伤情况。使用磁共振成像扫描确定每个解剖部位（包括外侧股骨髁、外侧胫骨平台、内侧股骨髁和内侧胫骨平台）的骨挫伤位置和严重程度。将四个解剖部位的内外侧和前后方向的骨挫伤细分为六个区域。骨挫伤的严重程度按1-4级进行分级。利用放射学信息系统在膝关节股骨和胫骨侧的矢状面和冠状面上评估骨挫伤的位置和严重程度。
结果
磁共振成像扫描中骨挫伤的发生率如下：外侧股骨髁为78.49%，外侧胫骨平台为88.17%，内侧股骨髁为49.46%，内侧胫骨平台为69.89%。外侧股骨髁、外侧胫骨平台、内侧股骨髁和内侧胫骨平台最常见且最严重的区域分别为中外侧（CL）、后内侧（PM）、CL和后外侧（PL）区域。
结论
患者骨挫伤的位置模式和严重程度表明，胫骨内旋、外翻以及胫骨的前向和外侧移位是非接触性前交叉韧带损伤的主要机制。
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