Genç Ahmet Serhat, Yalçınkaya Mirsad, Ermiş Egemen, Akdemir Enes, Anıl Berna, Salkılıç Esra Korkmaz, Şahin Eren, Yılmaz Ali Kerim
Department of Orthopedics and Traumatology, Samsun Education and Research Hospital, Samsun, 55090, Türkiye.
Department of Radiology, Samsun Education and Research Hospital, Samsun, 55090, Türkiye.
BMC Musculoskelet Disord. 2025 Jun 3;26(1):553. doi: 10.1186/s12891-025-08799-2.
BACKGROUND: This study aimed to examine the relationships between anterior tibial translation (ATT) distance, femorotibial rotation (FTR) angle, coronal lateral collateral ligament (LCL) sign, and functional lower extremity results obtained from single leg hop tests (SLHT), which are indirect magnetic resonance imaging (MRI) findings used to assess knee instability following anterior cruciate ligament (ACL) tear detection and ACL reconstruction (ACLR). METHODS: This study included a total of 28 patients, 12 females (43%) and 16 males (57%), aged 18-40 years with ACL tear. Pre-operative (pre-op) ATT distance, FTR angle and LCL sign were measured by MRI, and Lysholm Knee Scoring Scale (LKSS), International Knee Documentation Committee Score (IKDC) and Tegner Activity Score (TAS) were measured and recorded by patient self-assessment. At six months post-operatively (post-op), the SLHT test was conducted alongside the same measurements. Differences between pre-op and post-op results, as well as correlations between post-op test outcomes, were analyzed based on the presence of the LCL sign. RESULTS: After ACLR, there was no significant difference in ATT distance (p = 0.061) or FTR angle (p = 0.470) compared to the pre-op period. The presence of the post-op LCL sign did not lead to significant differences in ATT distance, FTR angle, LKSS, TAS, or any SLHT results (p > 0.05). However, the presence of LCL sign was associated with a significant increase in the IKDC scale (p = 0.047, ES=-0.78). In analyzing the correlations between ATT, FTR results, their changes, knee scores, SLHT results on the operative side, and limb symmetry index (LSI) ratios, significant correlations were found in various parameters for the entire group and the group without the LCL sign. In contrast, no significant correlations were found between any parameters in the group with the LCL sign (p > 0.05). CONCLUSIONS: ACLR did not result in a significant change in indirect MRI findings (ATT distance, FTR angle, and LCL sign) at the 6-month post-op mark. Additionally, the LCL sign was not a distinguishing factor in knee scores or lower extremity functional performance at six months post-op. In order to understand the potential effects of the LCL finding, longer follow-up and studies evaluating various sub-parameters such as age, gender, different surgical techniques are needed.
背景：本研究旨在探讨胫骨前移（ATT）距离、股胫旋转（FTR）角度、冠状面外侧副韧带（LCL）征与单腿跳测试（SLHT）所获得的下肢功能结果之间的关系，这些是用于评估前交叉韧带（ACL）撕裂检测和ACL重建（ACLR）后膝关节不稳定的间接磁共振成像（MRI）结果。 方法：本研究共纳入28例年龄在18 - 40岁的ACL撕裂患者，其中女性12例（43%），男性16例（57%）。术前通过MRI测量ATT距离、FTR角度和LCL征，患者通过自我评估测量并记录Lysholm膝关节评分量表（LKSS）、国际膝关节文献委员会评分（IKDC）和Tegner活动评分（TAS）。术后6个月，进行SLHT测试并同时进行相同测量。根据LCL征的存在情况分析术前和术后结果的差异以及术后测试结果之间的相关性。 结果：ACLR术后，与术前相比，ATT距离（p = 0.061）或FTR角度（p = 0.470）无显著差异。术后LCL征的存在在ATT距离、FTR角度、LKSS、TAS或任何SLHT结果方面未导致显著差异（p > 0.05）。然而，LCL征的存在与IKDC量表的显著增加相关（p = 0.047，效应量=-0.78）。在分析ATT、FTR结果、其变化、膝关节评分、手术侧SLHT结果和肢体对称指数（LSI）比率之间的相关性时，在整个组和无LCL征的组中，各种参数之间发现了显著相关性。相比之下，有LCL征的组中任何参数之间均未发现显著相关性（p > 0.05）。 结论：ACLR术后6个月，间接MRI结果（ATT距离、FTR角度和LCL征）无显著变化。此外，LCL征在术后6个月的膝关节评分或下肢功能表现中不是一个区分因素。为了了解LCL发现的潜在影响，需要更长时间的随访以及评估年龄、性别、不同手术技术等各种子参数的研究。
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