Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina-Chapel Hill, Raleigh, North Carolina, USA.
J Orthop Res. 2022 Jul;40(7):1613-1620. doi: 10.1002/jor.25198. Epub 2021 Nov 2.
Anterior cruciate ligament (ACL) injuries are increasingly common in adolescents, and injuries in this age-group are associated with many unique challenges. Recent large animal studies suggest that the size and function of the major bundles of the ACL change differently throughout skeletal growth. To better aid clinical treatment of pediatric partial ACL tears and better predict outcomes from age-specific treatments, there is a need to measure changes in ACL bundle size in humans during growth. As such, the objective of this study was to compare changes in the length and cross-sectional area (CSA) of the ACL and its primary bundles in adolescent human subjects. Magnetic resonance imaging (MRI) scans were analyzed to determine the visibility and integrity of the ACL and its anteromedial and posterolateral bundles. MRI scans were considered from a retrospective database of subjects ranging from 10 to 18 years of age. The ACL and its anteromedial and posterolateral bundles were segmented and reconstructed into 3D models, and length and CSA were calculated. Total ACL length and CSA were greater in males compared with females, with a statistically significant interaction between age and sex for CSA. Sex had a significant effect on the CSA of both bundles. These sex-dependent differences emerge with moderate to large effect sizes (range: d = 0.50 to d = 1.23) beginning around 13 years of age. Along with ACL bundle structure-function relationships previously established in preclinical animal models, these findings may point toward biomechanical changes in the adolescent human ACL.
前交叉韧带 (ACL) 损伤在青少年中越来越常见，而该年龄段的损伤与许多独特的挑战有关。最近的大型动物研究表明，ACL 的主要束在骨骼生长过程中大小和功能的变化不同。为了更好地辅助儿科部分 ACL 撕裂的临床治疗，并更好地预测特定年龄段治疗的结果，需要在生长过程中测量 ACL 束大小的变化。因此，本研究的目的是比较青少年人体 ACL 及其主要束的长度和横截面积 (CSA) 的变化。对磁共振成像 (MRI) 扫描进行了分析，以确定 ACL 及其前内侧束和后外侧束的可见性和完整性。MRI 扫描来自一个从 10 岁到 18 岁的受试者的回顾性数据库。将 ACL 及其前内侧束和后外侧束分段并重建为 3D 模型，并计算长度和 CSA。与女性相比，男性的 ACL 和 CSA 更长，CSA 与年龄和性别之间存在显著的相互作用。性别对两个束的 CSA 都有显著影响。这些性别相关的差异在 13 岁左右开始出现，具有中等至较大的效应大小（范围：d=0.50 至 d=1.23）。这些发现与以前在临床前动物模型中建立的 ACL 束结构-功能关系一起，可能指向青少年 ACL 的生物力学变化。
