Güven Necip, Özkan Sezai, Turkozu Tulin, Yokus Adem, Adanas Cihan, Gokalp Mehmet Ata, Tokyay Abbas
Department of Orthopedics and Traumatology, 53000Van Yuzuncu Yil University, Van, Turkey.
Department of Radiology, 53000Van Yuzuncu Yil University, Van, Turkey.
J Orthop Surg (Hong Kong). 2022 Jan-Apr;30(1):23094990211069692. doi: 10.1177/23094990211069692.
Many factors in the etiology of anterior cruciate ligament (ACL) tears, predisposing factors related to knee morphology have also been reported. This study aimed to determine whether the Insall-Salvati (IS) index, which measures patella height, is a predisposing risk factor for ACL tears.
The IS index, patellar length (PL), and patellar tendon length (PTL) values of patients (study group) that underwent arthroscopic reconstruction for ACL tears obtained by preoperative magnetic resonance imaging (MRI) were compared with the index values in the preoperative MRIs of patients that underwent knee arthroscopy for reasons besides ACL tears. In addition, the anterior tibial translation (ATT) of both groups was also measured and compared on MRI images. The MRI findings of the subjects included in both study groups were arthroscopically confirmed.
The mean ages of the study group (n = 120) and control group (n = 90) were 29.1 ± 8.2 years and 31.8 ± 9.8 years, respectively. There was a statistically significant difference between the study and control groups in terms of the PL and PTL values ( = 0.016 and = 0.001, respectively). The IS index was statistically significantly higher in the study group with ACL tears ( = 0.009). The ATT was 8.61 ± 4.68 mm in the study group and 3.80 ± 1.92 mm in the control group. The ATT results of both groups were evaluated, and it was found that the study group was significantly higher than the control group ( = 0.001).
As a result of our current study, we observed higher IS index values in patients with ACL tears than in patients without ACL tears. It should be kept in mind that patella alta, which is associated with a high IS index as one of the factors of knee morphology associated with ACL tears, may play a role in the etiology of ACL tears.
前交叉韧带（ACL）撕裂的病因有多种因素，与膝关节形态相关的易感因素也有报道。本研究旨在确定用于测量髌骨高度的Insall-Salvati（IS）指数是否为ACL撕裂的易感危险因素。
将因ACL撕裂接受关节镜重建的患者（研究组）术前磁共振成像（MRI）获得的IS指数、髌腱长度（PL）和髌腱长度（PTL）值，与因ACL撕裂以外原因接受膝关节镜检查的患者术前MRI中的指数值进行比较。此外，还在MRI图像上测量并比较了两组的胫骨前移（ATT）。两个研究组纳入的受试者的MRI结果均经关节镜证实。
研究组（n = 120）和对照组（n = 90）的平均年龄分别为29.1±8.2岁和31.8±9.8岁。研究组和对照组在PL和PTL值方面存在统计学显著差异（分别为P = 0.016和P = 0.001）。ACL撕裂的研究组IS指数在统计学上显著更高（P = 0.009）。研究组的ATT为8.61±4.68mm，对照组为3.80±1.92mm。对两组的ATT结果进行评估，发现研究组显著高于对照组（P = 0.001）。
根据我们目前的研究结果，我们观察到ACL撕裂患者的IS指数值高于无ACL撕裂患者。应记住，作为与ACL撕裂相关的膝关节形态因素之一，与高IS指数相关的高位髌骨可能在ACL撕裂的病因中起作用。
