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膝关节半月板后角形态学改变与前交叉韧带损伤的相关性:一种新的生物学评估指标

Association of Morphological Changes in the Posterior Horn of the Meniscus of Knee With Anterior Cruciate Ligament Injury: A New Biological Evaluation Index.

作者信息

Zhu Yupeng, Wang Qizheng, Liu Ke, Zhao Weili, Wang Chenxi, Wang Honghao, Lang Ning

机构信息

Department of Radiology, Peking University Third Hospital, Beijing, China.

出版信息

Orthop J Sports Med. 2025 Mar 11;13(3):23259671251320657. doi: 10.1177/23259671251320657. eCollection 2025 Mar.

Abstract

BACKGROUND

The shape and size of the meniscus are closely related to the stability of the knee joint and the anterior cruciate ligament (ACL) injury. Studies have confirmed the correlation between meniscal morphology and isolated ACL injury.

PURPOSE

To investigate meniscal parameters, including morphological changes, in participants with isolated ACL injury.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

This retrospective study, conducted from January to December 2021, compared 70 patients with isolated ACL injury with 70 patients with intact ACL. The meniscal slopes and posterior meniscal angles were measured using magnetic resonance imaging. The meniscal slopes include the slope of the anterior horn of the medial meniscus (SAHMM), slope of the posterior horn of the medial meniscus (SPHMM), slope of the anterior horn of the lateral meniscus (SAHLM), and slope of the posterior horn of the lateral meniscus (SPHLM). The posterior meniscal angles include the posterior base angle of the medial meniscus (PBAMM) and the posterior base angle of the lateral meniscus (PBALM). The receiver operating characteristic (ROC) curve was used to analyze the value of meniscal morphological parameters in judging ACL injury.

RESULTS

The SPHMM in participants with ACL injury was greater (mean, 23.24° ± 3.42°) than that in participants without (mean, 21.88° ± 3.35°) ( = .019). The PBAMM of participants with ACL injury was significantly higher than that in participants with intact ACL (mean, 73.78° ± 6.32° vs 67.82° ± 5.88°) ( < .001). The ROC cutoff value for SPHMM was 20.65°, and values greater than this had 81.4% sensitivity and 45.7% specificity for ACL injury. The ROC cutoff value for PBAMM was 73.55°, and values greater than this had 54.3% sensitivity and 84.3% specificity.

CONCLUSION

The authors found a strong association between morphological changes in the SPHMM and ACL injury. Therefore, morphological changes in the meniscus can indicate ACL injury.

摘要

背景

半月板的形状和大小与膝关节的稳定性及前交叉韧带(ACL)损伤密切相关。研究已证实半月板形态与孤立性ACL损伤之间存在关联。

目的

研究孤立性ACL损伤患者的半月板参数,包括形态学变化。

研究设计

横断面研究;证据等级,3级。

方法

本回顾性研究于2021年1月至12月进行,将70例孤立性ACL损伤患者与70例ACL完整的患者进行比较。使用磁共振成像测量半月板斜率和半月板后角。半月板斜率包括内侧半月板前角斜率(SAHMM)、内侧半月板后角斜率(SPHMM)、外侧半月板前角斜率(SAHLM)和外侧半月板后角斜率(SPHLM)。半月板后角包括内侧半月板后基底角(PBAMM)和外侧半月板后基底角(PBALM)。采用受试者工作特征(ROC)曲线分析半月板形态学参数在判断ACL损伤中的价值。

结果

ACL损伤患者的SPHMM(均值为23.24°±3.42°)大于未损伤患者(均值为21.88°±3.35°)(P = 0.019)。ACL损伤患者的PBAMM显著高于ACL完整的患者(均值分别为73.78°±6.32°和67.82°±5.88°)(P < 0.001)。SPHMM的ROC截断值为20.65°,大于该值时对ACL损伤的敏感度为81.4%,特异度为45.7%。PBAMM的ROC截断值为73.55°,大于该值时对ACL损伤的敏感度为54.3%,特异度为84.3%。

结论

作者发现SPHMM的形态学变化与ACL损伤之间存在密切关联。因此,半月板的形态学变化可提示ACL损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d594/11905081/a316fba73605/10.1177_23259671251320657-fig1.jpg

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