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股骨髁形态及其对前交叉韧带重建的影响。

Femoral condyle configuration and its impact on anterior cruciate ligament reconstruction.

机构信息

Department for Orthopaedic and Trauma Surgery, Faculty of Medicine, University of Cologne, Cologne, Germany.

Department for Orthopaedic Surgery, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany.

出版信息

Technol Health Care. 2023;31(5):1607-1617. doi: 10.3233/THC-220640.

DOI:10.3233/THC-220640
PMID:36970923
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10578253/
Abstract

BACKGROUND

Rupture of the anterior cruciate ligament (ACL) is one of the most common knee injuries and has substantial impact on knee function. Beside primary ruptures, an increasing number of re-(re-)ruptures occur, representing a therapeutical challenge for the treating surgeon. Several risk factors for re-ruptures have been previously identified, including an increased tibial slope.

OBJECTIVE

In this study, we investigated the effect of femoral condyle configuration on ACL-ruptures and re-ruptures.

METHODS

In-vivo magnetic resonance imaging scans of three different groups of patients were compared. Group 1 included patients with an intact ACL on both sides, group 2 included patients with primary, unilateral ACL-rupture, while group 3 included patients with an ACL-re-rupture or re-(re-)rupture. Fourteen different variables were obtained and analyzed regarding their impact on ACL-re-(re-)rupture.

RESULTS

Overall, 334 knees were investigated. Our data allowed us to define parameters to identify anatomical configurations of bones associated with an increased risk of ACL-re-rupture. Our results show, that patients with ACL-re-rupture show increased radii of the extension facet of the lateral femoral condyle (p< 0.001) as well as of the extension facet of the medial femoral condyle (p< 0.001).

CONCLUSION

We conclude that a spherical femoral condyle form does influence the clinical outcome after ACL-reconstruction.

摘要

背景

前交叉韧带（ACL）撕裂是最常见的膝关节损伤之一，对膝关节功能有重大影响。除了初次撕裂外，越来越多的再（再）撕裂发生，这对治疗医生来说是一个治疗上的挑战。先前已经确定了一些再撕裂的危险因素，包括胫骨斜率增加。

目的

本研究我们调查了股骨髁形态对 ACL 撕裂和再撕裂的影响。

方法

比较了三组不同患者的体内磁共振成像扫描。第 1 组包括双侧 ACL 完整的患者，第 2 组包括单侧 ACL 初次撕裂的患者，第 3 组包括 ACL 再撕裂或再（再）撕裂的患者。获得并分析了 14 个不同的变量，以分析其对 ACL 再（再）撕裂的影响。

结果

共研究了 334 个膝关节。我们的数据使我们能够确定与 ACL 再撕裂风险增加相关的骨骼解剖结构参数。我们的结果表明，ACL 再撕裂患者的外侧股骨髁延伸面的半径（p<0.001）以及内侧股骨髁延伸面的半径（p<0.001）增加。

结论

我们得出结论，球形股骨髁形态确实会影响 ACL 重建后的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/4d436cdf9b91/thc-31-thc220640-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/8677d6777b48/thc-31-thc220640-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/d4e420205452/thc-31-thc220640-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/98ca95408412/thc-31-thc220640-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/4d436cdf9b91/thc-31-thc220640-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/8677d6777b48/thc-31-thc220640-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/d4e420205452/thc-31-thc220640-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/98ca95408412/thc-31-thc220640-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/10578253/4d436cdf9b91/thc-31-thc220640-g004.jpg

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本文引用的文献

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Rehabilitation After Anterior Cruciate Ligament Injury: Review of Current Literature and Recommendations.前交叉韧带损伤后的康复：当前文献综述与建议
Curr Rev Musculoskelet Med. 2022 Jun;15(3):170-179. doi: 10.1007/s12178-022-09752-9. Epub 2022 Apr 6.
3
Quadriceps and hamstring tendon autografts in ACL reconstruction yield comparably good results in a prospective, randomized controlled trial.
前瞻性随机对照试验表明，前交叉韧带重建中使用四头肌腱和腘绳肌腱自体移植物的效果相当。
Arch Orthop Trauma Surg. 2022 Feb;142(2):281-289. doi: 10.1007/s00402-021-03862-8. Epub 2021 Mar 19.
4
Effect of Slope and Varus Correction High Tibial Osteotomy in the ACL-Deficient and ACL-Reconstructed Knee on Kinematics and ACL Graft Force: A Biomechanical Analysis.胫骨高位截骨术在 ACL 缺失和 ACL 重建膝关节中对坡度和内翻矫正的影响：生物力学分析。
Am J Sports Med. 2021 Feb;49(2):410-416. doi: 10.1177/0363546520976147. Epub 2020 Dec 3.
5
Increased Radiographic Posterior Tibial Slope Is Associated With Subsequent Injury Following Revision Anterior Cruciate Ligament Reconstruction.影像学显示的胫骨后倾增加与前交叉韧带重建翻修术后的后续损伤相关。
Orthop J Sports Med. 2019 Nov 5;7(11):2325967119879373. doi: 10.1177/2325967119879373. eCollection 2019 Nov.
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