IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
Knee Surg Sports Traumatol Arthrosc. 2024 Aug;32(8):1992-2002. doi: 10.1002/ksa.12219. Epub 2024 Apr 30.
The purpose of this study was to assess the frequency of medial collateral ligament (MCL), posterior oblique ligament (POL) and anterolateral ligament (ALL) tears and different types of RAMP lesions of patients with verified acute anterior cruciate ligament (ACL) tears by magnetic resonance imaging (MRI).
MRI was performed on patients with a clinical diagnosis of acute ACL injury. Patients were eligible for inclusion if they had an initially clinically noted ACL tear confirmed on MRI within 30 days of trauma.
A total of 146 patients were included in the study, 42 (28.8%) females and 104 (71.2%) males. The mean age at MRI was 27.2 ± 9.4 years, and the mean time from injury to MRI was 15.7 ± 7.8 days. Thirty-four (23.3%) patients had a complete MCL lesion, 32 (21.9%) had a complete POL lesion and 28 (19.2%) had a complete ALL lesion. One hundred and fourteen patients (78.1%) presented with RAMP lesions, while 20 (13.7%) patients reported other meniscal lesions. The mean medial and lateral tibial slopes were 4.0° ± 2.7° and 4.0° ± 3.1°, respectively. Only 10 (6.8%) patients reported no lesions associated with ACL rupture. The most common injuries were isolated RAMP type 3 (18-12.3%) and isolated RAMP type 1 (17-11.6%). Thirteen (8.9%) patients had a combination of MCL, POL and ALL rupture.
Isolated lesions of the ACL are extremely rare. In most cases, a single RAMP lesion should be investigated. In the presence of MCL injury, POL injury should always be suspected as well, while nearly 20% of patients present a rupture of the ALL. About one in 10 patients had three lesions (MCL, ALL and POL), and most of them had a combined RAMP lesion.
Level IV.
本研究旨在通过磁共振成像（MRI）评估经证实的急性前交叉韧带（ACL）撕裂患者中内侧副韧带（MCL）、后斜韧带（POL）和前外侧韧带（ALL）撕裂以及不同类型的 RAMP 损伤的频率。
对临床诊断为急性 ACL 损伤的患者进行 MRI 检查。如果患者在创伤后 30 天内 MRI 证实存在最初临床诊断的 ACL 撕裂，则符合纳入标准。
共有 146 例患者纳入本研究，其中女性 42 例（28.8%），男性 104 例（71.2%）。MRI 时的平均年龄为 27.2±9.4 岁，从损伤到 MRI 的平均时间为 15.7±7.8 天。34 例（23.3%）患者存在完全 MCL 损伤，32 例（21.9%）患者存在完全 POL 损伤，28 例（19.2%）患者存在完全 ALL 损伤。114 例（78.1%）患者存在 RAMP 损伤，20 例（13.7%）患者存在其他半月板损伤。内侧和外侧胫骨斜率的平均值分别为 4.0°±2.7°和 4.0°±3.1°。仅 10 例（6.8%）患者报告与 ACL 撕裂无关的损伤。最常见的损伤是孤立的 RAMP 3 型（18-12.3%）和孤立的 RAMP 1 型（17-11.6%）。13 例（8.9%）患者存在 MCL、POL 和 ALL 同时撕裂。
ACL 的单纯损伤极为罕见。在大多数情况下，应调查单个 RAMP 损伤。当存在 MCL 损伤时，应始终怀疑存在 POL 损伤，而近 20%的患者存在 ALL 撕裂。约十分之一的患者存在 3 处损伤（MCL、ALL 和 POL），其中大多数患者存在 RAMP 联合损伤。
IV 级。
