Ubl Steffen T, Harmes Johannes C, Koch Evamaria, Wafaisade Arasch, Guenther Daniel, Bouillon Bertil, Pfeiffer Thomas R
Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center Witten/Herdecke University Cologne Germany.
Institute of Interventional and Diagnostic Radiology and Neuroradiology University Hospital Essen Essen Germany.
J Exp Orthop. 2024 Nov 4;11(4):e70078. doi: 10.1002/jeo2.70078. eCollection 2024 Oct.
To clarify whether different methods of quantifying lateral femoral condyle (LFC) bone morphology as risk factors for anterior cruciate ligament (ACL) injury on lateral radiographs should be considered as individual risk factors and to assess inter- and intraobserver reliability.
We retrospectively reviewed 487 patients undergoing primary ACL reconstruction at our institution. Routine lateral radiographs of the injured knees were utilized to measure the following parameters: LFC ratio (LFCR), height of LFC to anteroposterior diameter ratio (HAPR), femur tibia size ratio (FTSR), tibia to posterior femoral condyle ratio (TPFCR) and Porto ratios (XY/AB; B/AB; B/XY). Malrotated radiographs were excluded. Pearson's correlation coefficients were used to identify relationships. Intraclass correlation coefficients were calculated for inter- and intraobserver reliability for two raters.
Fifty-eight patients were included. Means and standard deviations for LFCR were 63.7% ± 2.8%, HAPR 0.35 ± 0.02, FTSR 1.23 ± 0.07, TPFCR 2.99 ± 0.28, XY/AB 0.41 ± 0.08, B/AB 1.20 ± 0.06 and B/XY 3.05 ± 0.58. Significant correlations were observed between FTSR and XY/AB ( = 0.425), B/AB ( = 0.582) and TPFCR ( = -0.326), between XY/AB and HAPR ( = -0.309) and B/XY ( = -0.933) and between TPFCR and B/AB ( = 0.302). Intraobserver agreement was excellent for LFCR, HAPR, FTSR, TPFCR and B/AB and good for XY/AB and B/XY. Interobserver agreement varied from poor for XY/AB and B/XY, good for HAPR, B/AB, FTSR and TPFCR to excellent for LFCR.
Different methods of quantifying LFC bone morphology should be considered as individual risk factors, characterized by good to excellent intraobserver reliability, but highly variable interobserver reliability.
Level III.
明确在侧位X线片上，将不同的量化外侧股骨髁（LFC）骨形态作为前交叉韧带（ACL）损伤危险因素的方法是否应被视为独立的危险因素，并评估观察者间和观察者内的可靠性。
我们回顾性分析了在我院接受初次ACL重建的487例患者。利用受伤膝关节的常规侧位X线片测量以下参数：LFC比率（LFCR）、LFC高度与前后径比率（HAPR）、股骨胫骨尺寸比率（FTSR）、胫骨与股骨后髁比率（TPFCR）以及波尔图比率（XY/AB；B/AB；B/XY）。排除旋转不良的X线片。采用Pearson相关系数来确定关系。计算两名评估者的观察者间和观察者内可靠性中的组内相关系数。
纳入58例患者。LFCR的均值和标准差分别为63.7%±2.8%、HAPR为0.35±0.02、FTSR为1.23±0.07、TPFCR为2.99±0.28、XY/AB为0.41±0.08、B/AB为1.20±0.06、B/XY为3.05±0.58。观察到FTSR与XY/AB（=0.425）、B/AB（=0.582）和TPFCR（=-0.326）之间、XY/AB与HAPR（=-0.309）和B/XY（=-0.933）之间以及TPFCR与B/AB（=0.302）之间存在显著相关性。观察者内一致性在LFCR、HAPR、FTSR、TPFCR和B/AB方面为优，在XY/AB和B/XY方面为良。观察者间一致性在XY/AB和B/XY方面为差，在HAPR、B/AB、FTSR和TPFCR方面为良，在LFCR方面为优。
量化LFC骨形态的不同方法应被视为独立的危险因素，其特点是观察者内可靠性良好至优秀，但观察者间可靠性差异很大。
三级。
