Qiu Kaijie, Wang Canlong, Cheng Linxiang, Zou Yuxuan, Zhao Chenchen, Tang Zhaopeng, Fei Yang, Geng Jia, Shen Weiliang, Yang Guang, Pan Zongyou
Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, China.
Orthop J Sports Med. 2025 Aug 11;13(8):23259671251356626. doi: 10.1177/23259671251356626. eCollection 2025 Aug.
BACKGROUND: The morphological features of the femoral condyles have recently attracted attention as a potential risk factor for knee injuries. However, little is known about whether the femoral condylar morphology is related to posterior cruciate ligament (PCL) injury. PURPOSE: To investigate whether the morphological characteristics of the femoral condyle are risk factors for isolated PCL rupture. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: From the patients who visited the outpatient clinic of our hospital between 2012 and 2022, we included 78 patients with isolated PCL ruptures and 78 age- and sex-matched controls with knee injury but no structural damage evident on magnetic resonance imaging (MRI). The following parameters were assessed using MRI: the lateral femoral condyle and medial femoral condyle height and depth ratio (LFC-H/D, MFC-H/D), notch width index, intercondylar notch angle, the lateral tibial plateau slope, and medial tibial plateau slope (MTPS), and medial tibial depth. Values were compared between these 2 groups using the independent test and the Mann-Whitney test. Univariate logistic regression analysis was subsequently performed to identify independent risk factors. Receiver operating characteristic curves were generated for the morphological indicators and the combination of risk factors. RESULTS: Patients in the isolated PCL rupture group had significantly lower LFC-H/D (0.49 vs 0.52; < .001) and MTPS (7.34 vs 8.81; = .012) values compared with the control group. In sex-specific analyses, both male and female patients with isolated PCL rupture had a significantly lower LFC-H/D (female patients: 0.46 vs 0.52; < .001; male patients: 0.51 vs 0.52; = .035). In addition, male patients with PCL rupture had a smaller MTPS (6.74 mm vs 8.79 mm; = .004). Univariate logistic regression analysis further validated LFC-H/D (odds ratio [OR], <0.001; < .001) and MTPS (OR, 0.889; = .014) as risk factors for isolated PCL rupture. CONCLUSION: A decreased LFC-H/D and a reduced MTPS were identified as risk factors for isolated PCL rupture. Sex-specific analysis further suggested that a decreased LFC-H/D was a risk factor for isolated PCL ruptures in both male and female patients, whereas a lower MTPS was a risk factor exclusively in male patients.
背景：股骨髁的形态特征最近作为膝关节损伤的潜在危险因素受到关注。然而，关于股骨髁形态是否与后交叉韧带（PCL）损伤相关，人们知之甚少。 目的：研究股骨髁的形态特征是否为孤立性PCL断裂的危险因素。 研究设计：病例对照研究；证据等级，3级。 方法：从2012年至2022年到我院门诊就诊的患者中，我们纳入了78例孤立性PCL断裂患者和78例年龄及性别匹配的膝关节损伤对照者，这些对照者在磁共振成像（MRI）上无明显结构损伤。使用MRI评估以下参数：外侧股骨髁和内侧股骨髁的高度与深度比（LFC-H/D、MFC-H/D）、髁间切迹宽度指数、髁间切迹角、外侧胫骨平台坡度和内侧胫骨平台坡度（MTPS）以及内侧胫骨深度。使用独立t检验和Mann-Whitney U检验比较这两组之间的值。随后进行单因素逻辑回归分析以确定独立危险因素。为形态学指标和危险因素组合生成受试者操作特征曲线。 结果：与对照组相比，孤立性PCL断裂组患者的LFC-H/D（0.49对0.52；P<0.001）和MTPS（7.34对8.81；P = 0.012）值显著更低。在按性别进行的分析中，孤立性PCL断裂的男性和女性患者的LFC-H/D均显著更低（女性患者：0.46对0.52；P<0.001；男性患者：0.51对0.52；P = 0.035）。此外，PCL断裂的男性患者的MTPS更小（6.74 mm对8.79 mm；P = 0.004）。单因素逻辑回归分析进一步验证LFC-H/D（比值比[OR]，<0.001；P<0.001）和MTPS（OR，0.889；P = 0.014）为孤立性PCL断裂的危险因素。 结论：LFC-H/D降低和MTPS减小被确定为孤立性PCL断裂的危险因素。按性别进行的分析进一步表明，LFC-H/D降低是男性和女性患者孤立性PCL断裂的危险因素，而MTPS较低仅是男性患者的危险因素。
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