Sobota Jana, Arras Christian, Frings Jannik, Sobota Milan, Frosch Karl-Heinz, Krause Matthias
Department of Trauma and Orthopedic Surgery University Medical Center Hamburg-Eppendorf Hamburg Germany.
Sir William Dunn School of Pathology University of Oxford Oxford UK.
J Exp Orthop. 2025 Jul 13;12(3):e70360. doi: 10.1002/jeo2.70360. eCollection 2025 Jul.
The aim of this study was to evaluate external tibial rotation using magnetic resonance imaging (MRI) in patients with injuries to the posterolateral corner (PLC) of the knee.
A retrospective analysis of 26 patients with PLC injury (study group) was performed and compared with a control group of 100 patients without knee injuries. Intra-articular tibial rotation was assessed in MRI measuring two angles: (1) between the surgical epicondylar axis (SEA) of the femur and the posterior tibial condyle line (PTC) (SEA-PTC); and (2) between the posterior femoral condyle (PFC) and the PTC (PFC-PTC). Results were aligned with the dial test (DT), representing the clinical assessment of PLC injuries. The statistical significance of differences in SEA-PTC and PFC-PTC was evaluated using a two-sided Welch's test.
The mean SEA-PTC was -6.3 ± 7.9° (study group) versus -6.1° ± 4.0° (control group), and the mean PFC-PTC was -5.2 ± 2.4° (study group) versus -5.4 ± 1.5° (control group). There were no statistical differences regarding the SEA-PTC or the PFC-PTC between both groups ( = 0.87 and = 0.87, respectively). DT was positive in 80% of patients with PLC injury; thus, sensitivity was 80%. SEA-PTC and PFC-PTC were not statistically different between DT positive/negative patients ( = 0.89 and = 0.1, respectively). There was a significant correlation between SEA-PTC and PFC-PTC ( = 0.88; < 0.001).
PLC injuries are not associated with increased external tibial rotation in the MRI, while the DT is a valuable method for the clinical assessment of PLC injuries.
Level III.
本研究旨在利用磁共振成像（MRI）评估膝关节后外侧角（PLC）损伤患者的胫骨外旋情况。
对26例PLC损伤患者（研究组）进行回顾性分析，并与100例无膝关节损伤的对照组患者进行比较。在MRI上评估关节内胫骨旋转，测量两个角度：（1）股骨手术髁上轴（SEA）与胫骨后髁线（PTC）之间的角度（SEA-PTC）；（2）股骨后髁（PFC）与PTC之间的角度（PFC-PTC）。结果与表盘试验（DT）进行比对，表盘试验代表PLC损伤的临床评估。使用双侧韦尔奇检验评估SEA-PTC和PFC-PTC差异的统计学意义。
SEA-PTC的平均值在研究组为-6.3±7.9°，在对照组为-6.1°±4.0°；PFC-PTC的平均值在研究组为-5.2±2.4°，在对照组为-5.4±1.5°。两组之间在SEA-PTC或PFC-PTC方面无统计学差异（分别为=0.87和=0.87）。80%的PLC损伤患者DT呈阳性；因此，敏感性为80%。DT阳性/阴性患者之间的SEA-PTC和PFC-PTC无统计学差异（分别为=0.89和=0.1）。SEA-PTC与PFC-PTC之间存在显著相关性（=0.88；<0.001）。
PLC损伤在MRI中与胫骨外旋增加无关，而表盘试验是PLC损伤临床评估的一种有价值的方法。
三级。
