Patients with high-grade pivot-shift phenomenon are associated with higher prevalence of anterolateral ligament injury after acute anterior cruciate ligament injuries
Patients with high-grade pivot-shift phenomenon are associated with higher prevalence of anterolateral ligament injury after acute anterior cruciate ligament injuries
复制标题
患有高度枢轴移位现象的患者与急性前交叉韧带损伤后前外侧韧带损伤的发生率较高相关。
DOI：
10.1007/s00167-017-4492-z
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发表时间：
2017-04-01
影响因子：
3.8
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
比较急性前交叉韧带（ACL）损伤后重度（II、III级）枢轴移位和低度（0、I级）枢轴移位现象患者并发前外侧韧带（ALL）损伤的发生率。 选取68例出现重度（II、III级）枢轴移位现象的急性ACL损伤患者作为研究组。他们以 1:1 的方式与另外 68 名 ACL 受伤的对照参与者进行匹配，这些对照参与者在同一研究期间表现出低级（0 级和 I 级）枢轴移位现象。患者按年龄、性别和受伤到手术的时间进行匹配。所有患者均在麻醉下进行标准化枢轴移位测试。两名不知情的肌肉骨骼放射科医生检查了磁共振成像 (MRI) 扫描是否存在伴随的 ALL 损伤。 ALL损伤的等级分为0级（正常）、I级（扭伤）、II级（部分撕裂）和III级（完全撕裂）。进一步比较研究组与对照组伴ALL损伤的发生率及分级。总体而言，研究组伴ALL损伤的发生率（94.1%，64/68）显着高于对照组[60.3%，（41/68），P < 0.05]。具体而言，有 49 名患者（49/64，76.6%）表现出 II/III 级（部分/完全撕裂）伴随 ALL 损伤的 MRI 证据，也显着高于对照组（12/41，29.3%）。急性 ACL 损伤后，与低度枢轴移位现象患者相比，存在高级别枢轴移位现象的患者伴随 ALL 损伤的发生率更高。应考虑对这种伴随损伤进行仔细评估和适当治疗，特别是对于具有高级枢轴移位现象的膝盖。
To compare the prevalence of concomitant anterolateral ligament (ALL) injury between patients with high-grade (grades II and III) pivot-shift and those with low-grade (grades 0 and I) pivot-shift phenomenon after acute anterior cruciate ligament (ACL) injuries.Sixty-eight patients with an acute ACL injury who showed high-grade (grades II and III) pivot-shift phenomenon were enrolled as the study group. They were matched in a 1:1 fashion to another 68 ACL-injured control participants who showed low-grade (grades 0 and I) pivot-shift phenomenon during the same study period. Patients were matched by age, sex, and time from injury to surgery. A standardized pivot-shift test was performed under anesthesia for all the patients. Two blinded musculoskeletal radiologists reviewed the magnetic resonance imaging (MRI) scans for the presence of concomitant ALL injury. The grade of an ALL injury was divided into grade 0 (normal), grade I (sprain), grade II (partial tear), and grade III (complete tear). The prevalence and the grade of concomitant ALL injury were further compared between the study group and the control group.Overall, the prevalence of concomitant ALL injury in the study group (94.1%, 64/68) was significantly higher than that in the control group [60.3%, (41/68), P < 0.05]. Specifically, there were 49 patients (49/64, 76.6%) who showed grade II/III (partial/complete tear) MRI evidence of concomitant ALL injury, which was also significantly higher than that in the control group (12/41, 29.3%).Patients with high-grade pivot-shift phenomenon showed higher prevalence of concomitant ALL injury compared to those with low-grade pivot-shift phenomenon after acute ACL injuries. Careful assessment and proper treatment of this concomitant injury should be considered especially in knees with high-grade pivot-shift phenomenon.III.