股骨外髁矢状位构形与前交叉韧带损伤的关系△

Relationship between sagittal configuration of femoral lateral condyle and anterior cruciate ligament injury

摘要:

［目的］ 探讨股骨外髁矢状位构形相关解剖形态参数对前交叉韧带 （anterior cruciate ligament, ACL） 损伤的影响。 ［方法］ 回顾性分析 2017 年 1 月—2020 年 1 月膝关节镜手术治疗的 100 例患者的临床资料。其中，50 例为 ACL 损伤 （损伤组），50 例为单纯半月板损伤 （对照组）。测量并比较患者术前影像股骨外髁指数 （lateral femoral condylar index, LFCI） 和股骨外髁后髁比等指标，并与是否 ACL 损伤行 ROC 分析。［结果］损伤组后髁直径、LFCI 显著小于对照组（P<0.05），但两组前髁直径的差异无统计学意义 （P>0.05）。损伤组股骨远端直径较对照组大 （P<0.05），但损伤组股骨后髁比显著小于对照组 （P< 0.05），两组后髁偏心距的差异无统计学意义 （P>0.05）。ROC 分析显示，LFCI 和股骨外髁后髁比的曲线下面积 （area under curve, AUC）分别为 0.717、0.713。［结论］LFCI 和股骨外髁后髁比可视为预测前交叉韧带损伤的指标。

Abstract:

[Objective] To investigate the effects of sagittal configuration related anatomical morphology parameters of lateral femoral condyle on anterior cruciate ligament (ACL) injury. [Methods] A retrospective study was conducted on 100 patients who received knee ar- throscopic surgery from January 2017 to January 2020. Of them, 50 patients had ACL injury (the injury group) and 50 patients had simple meniscus injury (the control group) . The lateral femoral condylar index (LFCI) and the posterior condylar ratio of lateral femoral condyle were measured and compared between the two groups, while ROC analysis was performed for ACL injury. [Results] The posterior condyle diameter and LFCI of the injured group were significantly lower than those of the control group (P＜0.05) , but there was no significant differ- ence in anterior condyle diameter between the two groups (P＞0.05) . The distal femoral diameter of the injured group was larger than that of the control group (P＜0.05) , but the posterior condylar ratio of the injured group was significantly smaller than that of the control group (P＜ 0.05) , and there was no statistically significant difference in the posterior condyle eccentricity between the two groups (P＞0.05) . As results of ROC analysis, the area under curve (AUC) of LFCI and posterior condylar ratio of lateral femur condyle were 0.717 and 0.713, respective- ly. [Conclusion] LFCI and posterior condylar ratio of the lateral femoral condyle might be regarded as predictors of ACL injury.