Micicoi Grégoire, Jacquet Christophe, Khakha Raghbir, LiArno Sally, Faizan Ahmad, Seil Romain, Kocaoglu Baris, Cerciello Simone, Martz Pierre, Ollivier Matthieu
iULS-University Institute for Locomotion and Sports, Nice, France.
Institute of Movement and Locomotion, Aix-Marseille University, APHM, CNRS, ISM, Marseille, France.
Am J Sports Med. 2021 Dec;49(14):3816-3824. doi: 10.1177/03635465211050421. Epub 2021 Oct 28.
Anterior cruciate ligament (ACL) injuries are multifactorial events that may be influenced by morphometric parameters. Associations between primary ACL injuries or graft ruptures and both femoral and tibial bony risk factors have been well described in the literature.
To determine values of femoral and tibial bony morphology that have been associated with ACL injuries in a reference population. Further, to define interindividual variations according to participant demographics and to identify the proportion of participants presenting at least 1 morphological ACL injury risk factor.
Cross-sectional study; Level of evidence, 3.
Computed tomography scans of 382 healthy participants were examined. The following bony ACL risk factors were analyzed: notch width index (NWI), lateral femoral condylar index (LFCI), medial posterior plateau tibial angle (MPPTA), and lateral posterior plateau tibial angle (LPPTA). The proportion of this healthy population presenting with at least 1 pathological ACL injury risk factor was determined. A multivariable logistic regression model was constructed to determine the influence of demographic characteristics.
According to published thresholds for ACL bony risk factors, 12% of the examined knees exhibited an intercondylar notch width <18.9 mm, 25% had NWI <0.292, 62% exhibited LFCI <0.67, 54% had MPPTA <83.6°, and 15% had LPPTA <81.6°. Only 14.4% of participants exhibited no ACL bony risk factors, whereas 84.5% had between 2 and 4 bony risk factors and 1.1% had all bony risk factors. The multivariate analysis demonstrated that only the intercondylar notch width ( < .0001) was an independent predictor according to both sex and ethnicity; the LFCI ( = .012) and MMPTA ( = .02) were independent predictors according to ethnicity.
The precise definition of bony anatomic risk factors for ACL injury remains unclear. Based on published thresholds, 15% to 62% of this reference population would have been considered as being at risk. Large cohort analyses are required to confirm the validity of previously described morphological risk factors and to define which participants may be at risk of primary ACL injury and reinjury after surgical reconstruction.
前交叉韧带（ACL）损伤是多因素事件，可能受形态学参数影响。原发性ACL损伤或移植物破裂与股骨和胫骨骨危险因素之间的关联在文献中已有充分描述。
确定在参考人群中与ACL损伤相关的股骨和胫骨骨形态学值。此外，根据参与者的人口统计学特征定义个体间差异，并确定至少存在1种ACL损伤形态学危险因素的参与者比例。
横断面研究；证据等级，3级。
对382名健康参与者的计算机断层扫描进行检查。分析以下骨ACL危险因素：髁间窝宽度指数（NWI）、外侧股骨髁指数（LFCI）、胫骨内侧后平台角（MPPTA）和胫骨外侧后平台角（LPPTA）。确定该健康人群中至少存在1种病理性ACL损伤危险因素的比例。构建多变量逻辑回归模型以确定人口统计学特征的影响。
根据已公布的ACL骨危险因素阈值，12%的受检膝关节髁间窝宽度<18.9 mm，25%的NWI<0.292，62%的LFCI<0.67，54%的MPPTA<83.6°，15%的LPPTA<81.6°。只有14.4%的参与者没有ACL骨危险因素，而84.5%的参与者有2至4个骨危险因素，1.1%的参与者有所有骨危险因素。多变量分析表明，仅髁间窝宽度（<.0001）是根据性别和种族的独立预测因素；LFCI（=.012）和MPPTA（=.02）是根据种族的独立预测因素。
ACL损伤的骨解剖危险因素的确切定义仍不明确。根据已公布的阈值，该参考人群的15%至62%会被认为处于危险中。需要进行大型队列分析以确认先前描述的形态学危险因素的有效性，并确定哪些参与者可能有原发性ACL损伤和手术重建后再损伤的风险。
