Kwak Yoon Hae, Nam Ji-Hoon, Koh Yong-Gon, Kang Kyoung-Tak
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.
Orthop J Sports Med. 2021 Sep 2;9(9):23259671211022690. doi: 10.1177/23259671211022690. eCollection 2021 Sep.
Reports of anterior cruciate ligament (ACL) injury in patients with skeletal immaturity have been increasing. Variations in knee joint anatomy have been linked to ACL injury risk factors.
To identify associations between ACL injury, patella alta, and femoral trochlear dysplasia in patients with skeletal immaturity by using magnetic resonance imaging (MRI).
Cross-sectional study; Level of evidence, 3.
This retrospective study included 231 patients with skeletal immaturity-116 with acute complete noncontact ACL injury and 115 without ACL injury (controls)-who underwent knee MRI. Cases of femoral trochlear dysplasia were divided into 4 types according to the Dejour classification scheme. Patellar height and patellar tendon length were measured via sagittal MRI, and the Insall-Salvati ratio (ISR) was calculated.
In the ACL injury group, 56 (48.3%) knees exhibited trochlear dysplasia, including 51 (91.1%) that were Dejour type A; and in the control group, 12 (10.4%) knees exhibited trochlear dysplasia, 12 (100%) Dejour type A. The prevalence of femoral trochlear dysplasia was significantly higher in the ACL injury group than in the control group ( < .001). The ISR was not significantly different between the ACL injury and control groups (0.9 ± 0.2 vs 1 ± 0.2 mm; = .16). The correlation between ISR >1.2 and presence of ACL injury was not significant.
Femoral trochlear dysplasia was associated with ACL injury in patients with skeletal immaturity. In particular, Dejour type A femoral trochlear dysplasia was correlated with ACL injury patients with skeletal immaturity. Also, the possibility of ACL damage exists in patients with skeletal immaturity and femoral trochlear dysplasia.
骨骼未成熟患者前交叉韧带（ACL）损伤的报告一直在增加。膝关节解剖结构的变异与ACL损伤风险因素有关。
通过磁共振成像（MRI）确定骨骼未成熟患者ACL损伤、高位髌骨和股骨滑车发育不良之间的关联。
横断面研究；证据等级，3级。
这项回顾性研究纳入了231例骨骼未成熟患者，其中116例为急性完全性非接触性ACL损伤患者，115例无ACL损伤患者（对照组），均接受了膝关节MRI检查。股骨滑车发育不良病例根据Dejour分类方案分为4型。通过矢状面MRI测量髌骨高度和髌腱长度，并计算Insall-Salvati比率（ISR）。
在ACL损伤组中，56例（48.3%）膝关节表现为滑车发育不良，其中51例（91.1%）为Dejour A型；在对照组中，12例（10.4%）膝关节表现为滑车发育不良，12例（100%）为Dejour A型。ACL损伤组股骨滑车发育不良的患病率显著高于对照组（P<0.001）。ACL损伤组与对照组的ISR无显著差异（0.9±0.2 vs 1±0.2；P=0.16）。ISR>1.2与ACL损伤存在之间的相关性不显著。
股骨滑车发育不良与骨骼未成熟患者的ACL损伤有关。特别是，Dejour A型股骨滑车发育不良与骨骼未成熟的ACL损伤患者相关。此外，骨骼未成熟且股骨滑车发育不良的患者存在ACL损伤的可能性。
