Department of Orthopaedic Surgery, Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China.
Department of Radiology, Third Xiangya Hospital of Central South University, Changsha, China.
Knee Surg Sports Traumatol Arthrosc. 2023 Jun;31(6):2349-2357. doi: 10.1007/s00167-022-07068-2. Epub 2022 Jul 17.
This study aimed to assess the distribution of different anterior cruciate ligament (ACL) tear locations in different magnetic resonance imaging (MRI) planes, and to explore the relationships of ACL tear types with both meniscus injuries and bone bruising.
A retrospective study was performed in patients under 60 years old who underwent MRI scans in the sagittal and coronal oblique planes of the knee for ACL tears between 2014 and 2020. Patients with reports of chronic tears, partial tears, or prior surgeries were excluded. Tear locations were classified into five types, and the meniscus tear measurement variables included the presence of ramp, root, bucket-handle, and other types of tears. All injuries were confirmed by arthroscopy. Meanwhile, the presence and location of bone bruising were analysed and scored with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) bone bruising subscale.
A total of 291 patients were included. The prevalence rates of type I and type III injuries were 23/291 (7.9%) and 145/291 (49.8%) in the sagittal plane and 22/291 (7.6%) and 179/291 (61.5%) in the oblique coronal plane, respectively. The prevalence of medial meniscus tears with ACL tears was 126/291 (43.3%), while that of lateral meniscus tears with ACL tears was 77/291 (26.5%). The highest prevalence of medial meniscus injury with ACL tears was 15/22 (68.2%) for type I injuries. Bone bruises were located on the lateral femoral center in 125 patients (46%) and on the lateral tibia posterior in 132 patients (48%); the common areas of bone bruising were slightly correlated with type III ACL tears but not correlated with type I ACL tears.
The plane in which an MRI scan is performed affects the classification of ACL tears. The tear type is associated with the prevalence of medial meniscus injuries, and medial meniscus tears are most prevalent in type I ACL tears.
IV.
本研究旨在评估不同前交叉韧带（ACL）撕裂在不同磁共振成像（MRI）平面中的分布，并探讨 ACL 撕裂类型与半月板损伤和骨挫伤的关系。
回顾性分析 2014 年至 2020 年间在矢状面和冠状斜位 MRI 检查中诊断为 ACL 撕裂的年龄<60 岁患者。排除报告为慢性撕裂、部分撕裂或既往手术的患者。将撕裂部位分为 5 种类型，半月板撕裂的测量变量包括半月板上移、根撕裂、桶柄状撕裂和其他类型撕裂。所有损伤均经关节镜证实。同时，分析并根据全器官磁共振成像评分（WORMS）骨挫伤子量表对骨挫伤的存在和部位进行评分。
共纳入 291 例患者。矢状面 ACL 撕裂中 I 型和 III 型损伤的发生率分别为 23/291（7.9%）和 145/291（49.8%），冠状斜位 ACL 撕裂中 I 型和 III 型损伤的发生率分别为 22/291（7.6%）和 179/291（61.5%）。合并 ACL 撕裂的内侧半月板撕裂发生率为 126/291（43.3%），而合并 ACL 撕裂的外侧半月板撕裂发生率为 77/291（26.5%）。I 型损伤中内侧半月板撕裂发生率最高的是 15/22（68.2%）。125 例（46%）患者的骨挫伤位于外侧股骨中心，132 例（48%）患者的骨挫伤位于外侧胫骨后。骨挫伤的常见部位与 III 型 ACL 撕裂有一定相关性，但与 I 型 ACL 撕裂无相关性。
MRI 扫描的平面会影响 ACL 撕裂的分类。撕裂类型与内侧半月板损伤的发生率有关，内侧半月板撕裂在 I 型 ACL 撕裂中最常见。
IV 级。
