Greater Static Anterior Tibial Subluxation of the Lateral Compartment After an Acute Anterior Cruciate Ligament Injury Is Associated With an Increased Posterior Tibial Slope
Greater Static Anterior Tibial Subluxation of the Lateral Compartment After an Acute Anterior Cruciate Ligament Injury Is Associated With an Increased Posterior Tibial Slope
复制标题
急性前十字韧带损伤后，外侧间室更大的静态胫骨前半脱位与胫骨后坡度增加相关。
DOI：
10.1177/0363546518760580
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发表时间：
2018-06-01
影响因子：
4.8
通讯作者：
Feng, Hua
中科院分区：
文献类型：
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作者：
Song, Guan-yang;Zhang, Hui;Feng, Hua
背景：前交叉韧带(ACL)损伤后静止性胫骨前半脱位突出了胫骨相对于股骨的前位增加。然而，这一现象的确切原因并不完全清楚。研究设计：病例对照研究；证据水平3。方法：自2016年3月至2017年3月，对154例临床诊断为非接触性前交叉韧带损伤的患者进行了回顾性分析。术前在磁共振成像上测量外侧室相对于股骨外侧髁的静止性前半脱位。其中表现为>的患者23例(研究组)；结果：研究组侧脑室前半脱位平均为15.4度，显著大于对照组(8.8度)(P=10.0)，其中包括体重指数(BMI)、PTS、前外侧韧带损伤(ALL)以及伴随的半月板损伤。8.0[95%可信区间，2.729.2]；P<；。001)与急性前交叉韧带损伤后侧室前半脱位6 mm相关。结论：在急性非接触性前交叉韧带损伤中，PTS增加是导致外侧室前半脱位增加(<6 mm)的一个独立的解剖学危险因素。对于前交叉韧带损伤后胫骨前半脱位明显增加的患者，应测量PTS。
Background: Static anterior tibial subluxation of the lateral compartment after an anterior cruciate ligament (ACL) injury highlights an increased anterior position of the tibia relative to the femur. However, the precise cause of this phenomenon is not entirely clear. Recently, an increased posterior tibial slope (PTS) has been identified as an independent risk factor for noncontact ACL injuries.Hypothesis: An increased PTS is associated with an increased anterior position of the lateral compartment of the tibia relative to the femur after acute ACL injuries.Study Design: Case-control study; Level of evidence, 3.Methods: From March 2016 to March 2017, a total of 154 patients with clinically diagnosed noncontact ACL injuries who underwent primary ACL reconstruction were retrospectively analyzed. Static anterior subluxation of the lateral compartment relative to the lateral femoral condyle was measured on preoperative magnetic resonance imaging. Among them, 23 patients (study group) who demonstrated >= 6-mm anterior subluxation of the lateral compartment were matched in a 1: 1 fashion to 23 control participants (control group), who showed = 6 mm) static anterior subluxation of the lateral compartment, including body mass index (BMI), PTS, injuries to the anterolateral ligament (ALL), and concomitant lateral meniscal lesions, were assessed by multivariable conditional logistic regression analysis.Results: The mean PTS in the study group was 15.4 degrees, which was significantly larger than that in the control group (degrees 8.8) (P = 10.0 degrees) was determined to be an independent risk factor (odds ratio, 8.0 [95% CI, 2.729.2]; P < . 001) associated with >= 6-mm anterior subluxation of the lateral compartment after acute ACL injuries. However, BMI, presence of concomitant lateral meniscal lesions, and presence of ALL ruptures were not.Conclusion: An increased PTS was identified to be an independent anatomic risk factor of increased (>= 6 mm) anterior subluxation of the lateral compartment in acute noncontact ACL injuries. For patients with obviously increased anterior tibial subluxation of the lateral compartment after ACL injuries, the PTS should be measured.