利用剪切波弹性成像技术对年轻健康成年人的距腓前韧带和跟腓韧带进行生物力学评估。
Biomechanical evaluation of the anterior talo-fibular and calcaneo-fibular ligaments using shear wave elastography in young healthy adults.
机构信息
Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France; Département de chirurgie orthopédique adulte, hôpital de la Pitié-Salpêtrière, université de la Sorbonne, AP-HP, 75571 Paris, France.
Département de chirurgie orthopédique pédiatrique, hôpital Armand-Trousseau, université de la Sorbonne, AP-HP, 75571 Paris, France.
出版信息
Orthop Traumatol Surg Res. 2024 Feb;110(1):103647. doi: 10.1016/j.otsr.2023.103647. Epub 2023 Jun 24.
BACKGROUND
The objective of this study was to evaluate the stiffness of the anterior talo-fibular ligament (ATFL) and calcaneo-fibular ligament (CFL) using shear wave elastography (SWE) with the ankle in the neutral position and in varus, in young healthy adult volunteers. We also evaluated the reliability and reproducibility of the SWE measurements.
HYPOTHESIS
The stiffness of both ligaments increases with increasing ankle varus. SWE may be a reliable tool for evaluating the lateral collateral ligament complex of the ankle.
MATERIAL AND METHODS
We used SWE to evaluate both ankles of each of 20 healthy volunteers (10 females and 10 males). For each test, the foot was placed on a hinged plate and tested in the neutral position and in 15° and 30° of varus. Stiffness was evaluated based on shear wave velocity (SWV).
RESULTS
Stiffness of both the ATFL and CFL was minimal in the neutral position (2.06m/s and 3.43m/s, respectively). Stiffness increased significantly for both ligaments in 15° of varus (2.48m/s and 4.11m/s, respectively; p<0.0001) and was greatest in 30° of varus (3.15m/s and 4.57m/s, respectively; p<0.0001). ATFL stiffness was greater in males than in females in 15° (p=0.04) and 30° (p=0.02) of varus. For the CFL, in contrast, stiffness was not different between males and females. Stiffness of the ATFL and CFL was not associated with age, dominant side, height, or foot morphology. No correlations were found between stiffness of the two ligaments in any of the positions. Repeating each measurement three times produced excellent concordance for both ligaments in all three positions.
CONCLUSION
The ATFL and CFL are the main lateral stabilisers of the ankle, and each exerts a specific function. Their stiffness increases with the degree of varus. This study describes a protocol for evaluating ATFL and CFL density by SWE, which is a reliable and reproducible technique that provides a normal range.
LEVEL OF EVIDENCE
IV.
背景
本研究旨在使用剪切波弹性成像（SWE）评估中立位和内翻位踝关节前距腓韧带（ATFL）和跟腓韧带（CFL）的硬度。我们还评估了 SWE 测量的可靠性和可重复性。
假设
两条韧带的硬度随踝关节内翻程度的增加而增加。SWE 可能是评估踝关节外侧副韧带复合体的可靠工具。
材料和方法
我们使用 SWE 评估了 20 名健康志愿者（10 名女性和 10 名男性）的每只脚踝。对于每个测试，将脚放在铰链板上，并在中立位和内翻 15°和 30°时进行测试。根据剪切波速度（SWV）评估硬度。
结果
ATFL 和 CFL 的硬度在中立位时最小（分别为 2.06m/s 和 3.43m/s）。在 15°内翻时，两条韧带的硬度均显著增加（分别为 2.48m/s 和 4.11m/s，p<0.0001），在 30°内翻时最大（分别为 3.15m/s 和 4.57m/s，p<0.0001）。在 15°（p=0.04）和 30°（p=0.02）内翻时，男性的 ATFL 硬度大于女性。相反，CFL 的硬度在男性和女性之间没有差异。ATFL 和 CFL 的硬度与年龄、优势侧、身高或足部形态无关。在任何位置，都未发现两条韧带之间的硬度存在相关性。在所有三个位置，重复测量三次对两条韧带均产生了极好的一致性。
结论
ATFL 和 CFL 是踝关节的主要外侧稳定器，各自发挥特定的功能。它们的硬度随内翻程度的增加而增加。本研究描述了一种通过 SWE 评估 ATFL 和 CFL 密度的方案，该方案是一种可靠且可重复的技术，提供了正常范围。
证据水平
IV。
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