Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
McMaster University Medical Center, Division of Orthopaedic Surgery, Hamilton, Ontario, Canada.
Knee Surg Sports Traumatol Arthrosc. 2024 Jan;32(1):167-180. doi: 10.1002/ksa.12025. Epub 2024 Jan 4.
To determine bony knee morphological factors associated with primary posterior cruciate ligament (PCL) rupture or PCL graft failure after PCL reconstruction.
Three databases, namely MEDLINE, PubMed and EMBASE, were searched on 30th May 2023. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data such as receiver operating characteristic curve parameters, as well as p-values for comparisons of values between patients with PCL pathology and control patients, were recorded.
Nine studies comprising 1054 patients were included. Four studies reported that patients with PCL injury had flatter medial posterior tibial slopes (MTS) than controls, with mean values of 4.3 (range: 3.0-7.0) and 6.5 (range: 5.0-9.2) degrees, respectively. Two studies reported an MTS cutoff value ranging below 3.90-3.93° being a significant risk factor for primary PCL rupture or PCL graft failure. Two studies reported that shallow medial tibial depths were associated with primary PCL rupture, with mean values of 2.1 (range: 2.0-2.2) and 2.6 (range: 2.4-2.7) mm in PCL injury and control groups, respectively. Stenotic intercondylar notches and femoral condylar width were not consistently associated with PCL injuries.
Decreased MTS is associated with primary PCL rupture and graft failure after PCL reconstruction with values below 3.93° being considered as a significant risk factor. Less common risk factors include shallow medial tibial depth, while femoral condylar width and parameters with regards to the intercondylar notch, such as notch width, notch width index and intercondylar notch volume, demonstrated conflicting associations with primary or secondary PCL injuries.
Level III.
确定与前交叉韧带（PCL）重建后原发性后交叉韧带（PCL）撕裂或 PCL 移植物失败相关的骨性膝关节形态学因素。
作者于 2023 年 5 月 30 日在 MEDLINE、PubMed 和 EMBASE 三个数据库中进行了检索。作者遵守 PRISMA 和 R-AMSTAR 指南以及 Cochrane 干预系统评价手册。记录了受试者工作特征曲线参数以及患者与对照组之间的比较值的 p 值等数据。
共纳入 9 项研究，包括 1054 例患者。四项研究报告称，PCL 损伤患者的内侧后胫骨斜率（MTS）比对照组更平坦，平均值分别为 4.3（范围：3.0-7.0）和 6.5（范围：5.0-9.2）度。两项研究报告了一个 MTS 截断值，范围在 3.90-3.93°以下是原发性 PCL 撕裂或 PCL 移植物失败的显著危险因素。两项研究报告称，浅层内侧胫骨深度与原发性 PCL 撕裂相关，PCL 损伤组和对照组的平均值分别为 2.1（范围：2.0-2.2）和 2.6（范围：2.4-2.7）mm。狭窄的髁间切迹和股骨髁宽度与 PCL 损伤不一致相关。
MTS 降低与 PCL 重建后原发性 PCL 撕裂和移植物失败相关，低于 3.93°的值被认为是一个显著的危险因素。不太常见的危险因素包括浅层内侧胫骨深度，而股骨髁宽度以及髁间切迹的参数，如切迹宽度、切迹宽度指数和髁间切迹容积，与原发性或继发性 PCL 损伤表现出相互矛盾的关联。
III 级。
