Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai City, Zhejiang, China.
Department of Medical Education, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Linhai City, Zhejiang, China.
Knee Surg Sports Traumatol Arthrosc. 2024 Nov;32(11):3015-3022. doi: 10.1002/ksa.12346. Epub 2024 Jul 11.
To compare the difference of angle of the lower portion of the posterior cruciate ligament (PCL) measured via magnetic resonance imaging (MRI) in patients with and without partial anterior cruciate ligament (ACL) tears and to investigate the effectiveness of the angle of the lower portion of the PCL in diagnosing partial ACL tears.
From January 2022 to December 2022, a cohort of consecutive patients presenting with ACL tears who underwent ACL reconstruction and patients with isolated meniscus tears undergoing arthroscopic surgery were enroled for this study. The angle of the inferior portion of the PCL comprises α and β angles, and the posterior offset of the lateral condyle were measured on the MRI and compared between the partial ACL tear and control groups. Receiver operating characteristic curves, the areas under the curve (AUCs) and the 95% confidence intervals (CIs) were calculated to identify cutoff values for diagnosing partial ACL injuries.
Following an assessment of cohort eligibility and matching for age and sex, 100 patients were included in this study. The mean age of the cohort was 46.1 ± 10.3 years. The AUC for the α angle was 0.88 (95% CI, 0.82-0.94), with a sensitivity of 0.74 and specificity of 0.84 for predicting partial ACL ruptures; the α angle cutoff value was 73.6° (diagnostic odds ratio (OR), 14.10; 95% CI, 5.33-37.28). The AUC for the β angle was 0.86 (95% CI, 0.79-0.93), with a sensitivity of 0.64 and a specificity of 0.92 for predicting partial ACL ruptures; the β angle cutoff value was 73.3° (diagnostic OR, 14.54; 95% CI, 5.76-36.68).
A small α angle and a large β angle were associated with partial ACL tears. The angle of the distal portion of the PCL was simple to measure and reproducible, enhancing the diagnosis of partial ACL tears.
Level III.
比较 MRI 测量的后十字韧带(PCL)下部角度在部分前十字韧带(ACL)撕裂患者和无部分 ACL 撕裂患者之间的差异,并探讨 PCL 下部角度在诊断部分 ACL 撕裂中的有效性。
本研究纳入了 2022 年 1 月至 2022 年 12 月期间因 ACL 撕裂接受 ACL 重建的连续患者队列和因半月板撕裂接受关节镜手术的患者队列。PCL 下部角度由α角和β角组成,在 MRI 上测量外侧髁的后偏移,并在部分 ACL 撕裂组和对照组之间进行比较。计算受试者工作特征曲线、曲线下面积(AUC)和 95%置信区间(CI),以确定诊断部分 ACL 损伤的截断值。
在评估队列的纳入标准和年龄、性别匹配后,本研究纳入了 100 名患者。队列的平均年龄为 46.1±10.3 岁。α角的 AUC 为 0.88(95%CI,0.82-0.94),预测部分 ACL 撕裂的敏感性为 0.74,特异性为 0.84;α角的截断值为 73.6°(诊断比值比(OR),14.10;95%CI,5.33-37.28)。β角的 AUC 为 0.86(95%CI,0.79-0.93),预测部分 ACL 撕裂的敏感性为 0.64,特异性为 0.92;β角的截断值为 73.3°(诊断比值比(OR),14.54;95%CI,5.76-36.68)。
小的α角和大的β角与部分 ACL 撕裂有关。PCL 下部角度易于测量且可重复性好,有助于诊断部分 ACL 撕裂。
III 级。