Abstract：
BACKGROUND: Altered axial biomechanics of the knee are recognized as a risk factor for non-contact anterior cruciate ligament (ACL) injury. However, the relationship of knee and segmental torsion to non-contact ACL and combined anterolateral ligament (ALL) injury is unclear. This study aims to determine the relationship of knee and segmental torsion to non-contact ACL injury and to explore their relationship with ALL injuries.
METHODS: We divided 122 patients with arthroscopically confirmed non-contact ACL injuries into an ACL injury group (isolated ACL injury, 63 patients) and an ACL + ALL injury group (ACL combined with ALL injury,59 patients). Additionally, 90 normal patients with similar age, gender and body mass index (BMI) were matched as a control group. The tibial tubercle-trochlear groove (TT-TG) distance, distal femoral torsion (DFT), posterior femoral condylar torsion (PFCT) and proximal tibial torsion (PTT) were measured using magnetic resonance imaging (MRI). We assessed the differences between the groups using an independent samples t test and utilized receiver operating characteristic (ROC) curves to determine the cut-off value for the increased risk of ACL injury.
RESULTS: In patients with ACL injury, the measurements of the TT-TG (11.8 ± 3.1 mm), DFT (7.7° ± 3.5°) and PFCT (3.6° ± 1.3°) were significantly higher compared to the control group (9.1 ± 2.4 mm, 6.3° ± 2.7° and 2.8° ± 1.3°, respectively; P < 0.05), but the PTT did not differ between the two groups. The TT-TG, DFT and PFCT were not significantly larger in patients combined with ALL injury. ROC curve analysis revealed ACL injury is associated with TT-TG, DFT and PFCT.
CONCLUSIONS: Knee torsional alignment is associated with ACL injury, predominantly in the distal femur rather than the proximal tibia. However, its correlation with ALL injury remains unclear. These findings may help identify patients at high risk for non-contact ACL injury and inform the development of targeted prevention and treatment strategies.
METHODS: We divided 122 patients with arthroscopically confirmed non-contact ACL injuries into an ACL injury group (isolated ACL injury, 63 patients) and an ACL + ALL injury group (ACL combined with ALL injury,59 patients). Additionally, 90 normal patients with similar age, gender and body mass index (BMI) were matched as a control group. The tibial tubercle-trochlear groove (TT-TG) distance, distal femoral torsion (DFT), posterior femoral condylar torsion (PFCT) and proximal tibial torsion (PTT) were measured using magnetic resonance imaging (MRI). We assessed the differences between the groups using an independent samples t test and utilized receiver operating characteristic (ROC) curves to determine the cut-off value for the increased risk of ACL injury.
RESULTS: In patients with ACL injury, the measurements of the TT-TG (11.8 ± 3.1 mm), DFT (7.7° ± 3.5°) and PFCT (3.6° ± 1.3°) were significantly higher compared to the control group (9.1 ± 2.4 mm, 6.3° ± 2.7° and 2.8° ± 1.3°, respectively; P < 0.05), but the PTT did not differ between the two groups. The TT-TG, DFT and PFCT were not significantly larger in patients combined with ALL injury. ROC curve analysis revealed ACL injury is associated with TT-TG, DFT and PFCT.
CONCLUSIONS: Knee torsional alignment is associated with ACL injury, predominantly in the distal femur rather than the proximal tibia. However, its correlation with ALL injury remains unclear. These findings may help identify patients at high risk for non-contact ACL injury and inform the development of targeted prevention and treatment strategies.
摘要：
背景：膝关节轴向生物力学的改变被认为是非接触式前交叉韧带（ACL）损伤的危险因素。然而,膝关节和节段性扭转与非接触式ACL和前外侧韧带（ALL）联合损伤的关系尚不清楚。本研究旨在确定膝关节和节段扭转与非接触式ACL损伤的关系，并探讨它们与ALL损伤的关系。
方法：我们将122例经关节镜证实为非接触式ACL损伤的患者分为ACL损伤组（孤立的ACL损伤，63例患者）和ACLALL损伤组（ACL合并ALL损伤，59名患者）。此外,90例年龄相近的正常患者，将性别和体重指数(BMI)配对作为对照组.胫骨结节-滑车沟(TT-TG)距离,股骨远端扭转(DFT),使用磁共振成像（MRI）测量股骨后髁扭转（PFCT）和胫骨近端扭转（PTT）。我们使用独立样本t检验评估了组间的差异，并利用受试者工作特征（ROC）曲线来确定ACL损伤风险增加的临界值。
结果：ACL损伤患者，TT-TG的测量值（11.8±3.1mm），DFT（7.7°±3.5°）和PFCT（3.6°±1.3°）明显高于对照组（9.1±2.4mm，6.3°±2.7°和2.8°±1.3°,分别为；P<0.05)，但两组的PTT无差异.TT-TG,合并ALL损伤患者的DFT和PFCT均未显著增大。ROC曲线分析显示ACL损伤与TT-TG、DFT和PFCT。
结论：膝关节扭转对准与ACL损伤有关，主要在股骨远端，而不是胫骨近端。然而,其与ALL损伤的相关性尚不清楚。这些发现可能有助于识别非接触式ACL损伤的高风险患者，并为制定有针对性的预防和治疗策略提供信息。
方法：我们将122例经关节镜证实为非接触式ACL损伤的患者分为ACL损伤组（孤立的ACL损伤，63例患者）和ACLALL损伤组（ACL合并ALL损伤，59名患者）。此外,90例年龄相近的正常患者，将性别和体重指数(BMI)配对作为对照组.胫骨结节-滑车沟(TT-TG)距离,股骨远端扭转(DFT),使用磁共振成像（MRI）测量股骨后髁扭转（PFCT）和胫骨近端扭转（PTT）。我们使用独立样本t检验评估了组间的差异，并利用受试者工作特征（ROC）曲线来确定ACL损伤风险增加的临界值。
结果：ACL损伤患者，TT-TG的测量值（11.8±3.1mm），DFT（7.7°±3.5°）和PFCT（3.6°±1.3°）明显高于对照组（9.1±2.4mm，6.3°±2.7°和2.8°±1.3°,分别为；P<0.05)，但两组的PTT无差异.TT-TG,合并ALL损伤患者的DFT和PFCT均未显著增大。ROC曲线分析显示ACL损伤与TT-TG、DFT和PFCT。
结论：膝关节扭转对准与ACL损伤有关，主要在股骨远端，而不是胫骨近端。然而,其与ALL损伤的相关性尚不清楚。这些发现可能有助于识别非接触式ACL损伤的高风险患者，并为制定有针对性的预防和治疗策略提供信息。
