Ubl Steffen T, Vieider Romed P, Seilern Und Aspang Jesse, Gaebler Christian, Platzgummer Hannes
Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center Witten/Herdecke University Cologne Germany.
Department of Sports Orthopaedics, Klinikum Rechts der Isar Technical University of Munich Munich Germany.
J Exp Orthop. 2024 May 13;11(3):e12034. doi: 10.1002/jeo2.12034. eCollection 2024 Jul.
It is unclear whether different injury mechanisms lead to divergent anterior cruciate ligament (ACL) tear locations. This study aims to analyse the relationship between bone bruise (BB) distribution or depth and ACL tear location.
A retrospective analysis of 446 consecutive patients with acute non-contact ACL injury was performed. Only patients with complete ACL tears verified during subsequent arthroscopy were included. Magnetic resonance imaging (MRI) was used to classify BB location, BB depth, ACL tear location and concomitant injuries (medial/lateral meniscus and medial/lateral collateral ligament). Demographic characteristics included age, gender, body mass index (BMI), type of sport and time between injury and MRI. Multiple linear regression analysis was used to identify independent predictors of ACL tear location.
One hundred and fifty-eight skeletally mature patients met the inclusion criteria. The presence of BB in the lateral tibial plateau was associated with a more distal ACL tear location ( = -0.27, < 0.001). Less BB depth in the lateral femoral condyle showed a tendency towards more proximal ACL tears ( = -0.14; = 0.054). Older age predicted a more proximal ACL tear location ( = 0.31, < 0.001). No significant relationship was found between ACL tear location and gender, BMI, type of sport, concomitant injuries and time between injury and MRI.
ACL tear location after an acute non-contact injury is associated with distinct patterns of BB distribution, particularly involving the lateral compartment, indicating that different injury mechanisms may lead to different ACL tear locations.
Level III.
不同的损伤机制是否会导致前交叉韧带（ACL）撕裂部位不同尚不清楚。本研究旨在分析骨挫伤（BB）的分布或深度与ACL撕裂部位之间的关系。
对446例连续的急性非接触性ACL损伤患者进行回顾性分析。仅纳入随后关节镜检查证实为完全性ACL撕裂的患者。采用磁共振成像（MRI）对BB部位、BB深度、ACL撕裂部位及合并损伤（内侧/外侧半月板和内侧/外侧副韧带）进行分类。人口统计学特征包括年龄、性别、体重指数（BMI）、运动类型以及受伤至MRI检查的时间。采用多元线性回归分析确定ACL撕裂部位的独立预测因素。
158例骨骼成熟患者符合纳入标准。胫骨外侧平台存在BB与ACL撕裂部位更靠下有关（ = -0.27， < 0.001）。股骨外侧髁的BB深度较小显示出ACL撕裂部位更靠近近端的趋势（ = -0.14； = 0.054）。年龄较大预示着ACL撕裂部位更靠近近端（ = 0.31， < 0.001）。未发现ACL撕裂部位与性别、BMI、运动类型、合并损伤以及受伤至MRI检查的时间之间存在显著关系。
急性非接触性损伤后ACL撕裂部位与BB分布的不同模式有关，尤其是涉及外侧间室，这表明不同的损伤机制可能导致不同的ACL撕裂部位。
III级。
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