背景:在包括前交叉韧带(ACL)破裂患者和健康参与者在内的大型队列中,没有比较研究评估解剖学危险因素。
目的:确定哪些解剖参数与ACL破裂独立相关,以及个体和组合解剖参数的诊断价值。
方法:病例对照研究;证据水平,3.
方法:共有352名男性患者因原发性ACL断裂而接受关节镜ACL重建,年龄为350岁,sex-,身体质量指数-,和侧优势匹配的健康参与者被包括在内.进行32个先前确定的参数的测量和7个计算。计算组间差异。对个体和组合的独立相关因素进行单因素和多因素logistic回归模型和受试者工作特征曲线分析。
结果:所有参与者的平均年龄和体重指数分别为29.9±7.7岁和27.2±3.1。两组之间在切口宽度(NW)方面存在显着差异,缺口形状指数,胫骨前斜坡,缺口宽度指数,NW-隆起宽度(NW:EW)比,缺口高度,轴向侧壁角度,内侧髁间脊厚度,α角,胫骨内侧深度(MTD),胫骨外侧坡度(LTS),胫骨平台冠状宽度,隆起宽度指数,胫骨近端前后距离(TPAP),外侧髁前后距离(LCAP)/TPAP,ACL横截面积,ACL卷,内侧和外侧半月板软骨高度,内侧和外侧半月板软骨角(MCA),内侧和外侧半月板软骨骨高度。NW:EW比率(赔率比[OR],4.419;P=.017),MTD(或,8.617;P=.001),LTS(或,2.254;P=.011),LCAP/TPAP(或,2.782;P=.037),和中间MCA(或,1.318;P=.010)与ACL破裂的发展独立相关。结合独立相关因素显示出93%的敏感性和94%的特异性(曲线下面积,0.968)。
结论:通过联合使用NW:EW比率,可以将ACL破裂患者与未受伤的对照组区分开来,具有很高的敏感性和特异性。MTD,LTS,LCAP/TPAP,和中间MCA。在临床实践中,这些发现可能有助于制定ACL破裂的预防策略.
BACKGROUND: No comparative studies have evaluated anatomic risk factors in a large cohort including both patients with anterior cruciate ligament (ACL) ruptures and healthy participants.
OBJECTIVE: To determine which anatomic parameters are independently associated with an ACL rupture and the diagnostic values of the individual and combined anatomic parameters.
METHODS: Case-control study; Level of evidence, 3.
METHODS: A total of 352 male patients who underwent arthroscopic ACL reconstruction because of a primary ACL rupture and 350 age-, sex-, body mass index-, and side dominance-matched healthy participants were included. Measurements of 32 previously determined parameters and 7 calculations were performed. Between-group differences were calculated. Univariate and multivariate logistic regression models and receiver operating characteristic curve analysis were conducted for the individual and combined independently associated factors.
RESULTS: The mean age and body mass index of all participants were 29.9 ± 7.7 years and 27.2 ± 3.1, respectively. There were significant differences between the groups regarding the notch width (NW), notch shape index, anterior tibial slope, notch width index, NW-eminence width (NW:EW) ratio, notch height, axial lateral wall angle, medial intercondylar ridge thickness, alpha angle, medial tibial depth (MTD), lateral tibial slope (LTS), coronal tibial plateau width, eminence width index, tibial proximal anteroposterior distance (TPAP), lateral condylar anteroposterior distance (LCAP)/TPAP, ACL cross-sectional area, ACL volume, medial and lateral meniscal cartilage height, medial and lateral meniscal cartilage angle (MCA), and medial and lateral meniscal cartilage bone height. The NW:EW ratio (odds ratio [OR], 4.419; P = .017), MTD (OR, 8.617; P = .001), LTS (OR, 2.254; P = .011), LCAP/TPAP (OR, 2.782; P = .037), and medial MCA (OR, 1.318; P = .010) were independently associated with the development of an ACL rupture. Combining the independently associated factors revealed a sensitivity of 93% and a
specificity of 94% (area under the curve, 0.968).
CONCLUSIONS: Patients with ACL ruptures could be distinguished from uninjured controls with high sensitivity and
specificity via the combined use of the NW:EW ratio, MTD, LTS, LCAP/TPAP, and medial MCA. In clinical practice, these findings may contribute to the development of preventive strategies for ACL ruptures.