Musculoskeletal Radiology Department, Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, São Paulo, 05403-010, Brazil.
Hospital Sírio-Libanês, São Paulo, Brazil.
Eur Radiol. 2023 Feb;33(2):1456-1464. doi: 10.1007/s00330-022-09062-1. Epub 2022 Aug 17.
To evaluate anterolateral ligament abnormalities (ALL) at MRI scans and correlate with data from clinical instability tests (Lachman and pivot shift) performed under anesthesia in patients with acute anterior cruciate ligament (ACL) tears. Furthermore, perform multivariate analysis with other variables to isolate the ALL contribution to instability from other abnormalities.
Retrospective analysis of MRI and instability tests of 95 patients with ACL tears. The ALL was classified as no abnormality, abnormality without discontinuity, and discontinuity. Injuries in other knee ligament structures and menisci were also assessed. Results of instability tests (pivot shift and Lachman) with the patient anesthetized for arthroscopic ACL reconstruction were obtained from the patient database. Statistical analysis was performed using the IBM SPSS 22.
ALL abnormalities and iliotibial band (ITB), lateral (LCL), and medial (MCL) collateral ligament injuries showed a statistically significant correlation with the pivot shift test. The ALL MRI abnormalities were associated with the high-grade pivot shift results (p < 0.0005), with an odds ratio of 55.9 for high degrees of pivot shift in patients with abnormal ALL. The logistic model for all variables analyzed with the results of the pivot shift test demonstrated that the ALL was the only variable with a statistically significant correlation in the model (p < 0.0005).
MRI ALL abnormalities in patients with ACL injuries have a significant association with pivot shift test results in patients under anesthesia. The logistic model for high - grade pivot shift test results demonstrated that ALL abnormalities were the only variable with significant correlation.
• Evaluating the anterolateral ligament with MRI in acute anterior cruciate ligament injuries is useful to predict higher grades of pivot shift test in the moment of the arthroscopic reconstruction. • An abnormal anterolateral ligament presented an odds ratio of 55 for high degrees of pivot shift. • ALL MRI abnormalities association with knee instability is independent from other internal knee injuries.
评估急性前交叉韧带（ACL）撕裂患者 MRI 扫描中的前外侧韧带异常（ALL），并将其与麻醉下进行的临床不稳定测试（Lachman 和枢轴转移）的数据相关联。此外，通过其他变量进行多变量分析，以将 ALL 对不稳定的贡献与其他异常区分开来。
回顾性分析 95 例 ACL 撕裂患者的 MRI 和不稳定测试结果。将 ALL 分为无异常、无连续性异常和连续性异常。还评估了其他膝关节韧带结构和半月板的损伤。从患者数据库中获得了在关节镜 ACL 重建时麻醉下进行的不稳定测试（枢轴转移和 Lachman）的结果。使用 IBM SPSS 22 进行统计分析。
ALL 异常和髂胫束（ITB）、外侧（LCL）和内侧（MCL）侧副韧带损伤与枢轴转移试验有统计学显著相关性。ALL MRI 异常与高等级枢轴转移结果相关（p < 0.0005），在 ALL 异常患者中，高等级枢轴转移的优势比为 55.9。对所有分析变量与枢轴转移测试结果的逻辑模型表明，ALL 是模型中唯一具有统计学显著相关性的变量（p < 0.0005）。
ACL 损伤患者的 MRI ALL 异常与麻醉下患者的枢轴转移试验结果有显著相关性。高等级枢轴转移试验结果的逻辑模型表明，ALL 异常是唯一具有显著相关性的变量。
在急性前交叉韧带损伤中评估前外侧韧带的 MRI 有助于预测关节镜重建时枢轴转移试验的更高等级。
异常的前外侧韧带出现高等级枢轴转移的几率为 55。
ALL MRI 异常与膝关节不稳定的相关性独立于其他膝关节内部损伤。
