摘要
目的探讨青年男性膝关节解剖形态与非接触性前交叉韧带(ACL)损伤的相关性,为临床早期预防、科学运动提供依据。方法选取2020年6月至2023年5月就诊于联勤保障部队第九〇〇医院的84例非接触性ACL损伤的青年男性患者为损伤组,年龄24(21,28)岁,年龄范围为17~40岁,均经手术证实为ACL损伤,患者均于术前2周内行伤侧膝关节磁共振成像(MRI)检查。选取同期经临床和影像诊断确认无ACL损伤的81例青年男性为无损伤组,年龄26(22,31)岁,年龄范围为19~40岁。收集两组MRI检查资料以分析膝关节解剖形态差异,测量参数包括股骨髁宽度、股骨髁间窝深度、股骨髁间窝宽度、股骨髁间窝形态指数、股骨髁间窝宽度指数、胫骨内侧平台骨性坡度、胫骨内侧平台软骨坡度、胫骨外侧平台骨性坡度(LTS)、胫骨外侧平台软骨坡度(LCS)、胫骨冠状平台坡度(MLPS)、股骨轴-Blumensaat线角(FABA)。结果多因素logistic回归分析显示,FABA增大、LCS增大、MLPS增大是青年男性发生非接触性ACL损伤的独立危险因素(P<0.05);LTS增大是青年男性发生非接触性ACL损伤的独立保护因素(P<0.05)。FABA、MLPS、LTS、LCS预测非接触性ACL损伤的受试者操作特征(ROC)曲线的曲线下面积分别为0.890、0.668、0.705、0.830,灵敏度分别为0.690、0.714、0.762、0.857,特异度分别为0.938、0.556、0.605、0.778。通过Delong检验得出,FABA、LCS的ROC曲线下面积大于LTS、MLPS,差异有统计学意义(P<0.05);FABA与LCS的ROC曲线下面积比较,差异无统计学意义(P>0.05)。结论基于MRI测量的FABA、LTS、LCS、MLPS是青年男发生非接触性ACL损伤的独立影响因素,其中,FABA、LCS用于非接触性ACL损伤的预测价值较高。
Objective To explore the correlation between anatomical morphology of the knee joint and non-contact anterior cruciate ligament(ACL)injury in young males,and to provide evidence for early clinical prevention and scientific exercise.Methods A total of 84 young male patients with non-contact ACL injury admitted to the 900th Hospital of PLA Joint Logistic Support Force from June 2020 to May 2023 were selected as the injury group,aged 24(21,28)years old,ranged from 17 to 40 years old.All patients in the the injury group were diagnosed with ACL injury by surgery and magnetic resonance imaging(MRI)examination of the injured knee joint was performed within 2 weeks before the surgery.A total of 81 young men without ACL injury confirmed by clinical and imaging diagnosis were selected as the non-injury group,aged 26(22,31)years old,ranged from 19 to 40 years old.MRI examination data of the two groups were collected to analyze the anatomical morphological differences of the knee joint,including femoral condyle width,intercondylar height,intercondylar width,notch shape index,notch width index,medial tibial slope,medial-cartilage slope,lateral tibial slope(LTS),lateral-cartilage slope(LCS),medial-lateral plateau slope(MLPS)and femoral axis-Blumensaat line angle(FABA).Results Multivariate logistic regression analysis showed that an increase in FABA,LCS and MLPS were independent risk factors for non-contact ACL injury in young males(P<0.05),while an increase in LTS was an independent protective factor for non-contact ACL injury in young males(P<0.05).The area under receiver operating characteristic(ROC)curve of FABA,MLPS,LTS and LCS for predicting non-contact ACL injury was 0.890,0.668,0.705 and 0.830,with the sensitivity of 0.690,0.714,0.762 and 0.857,with the specificity of 0.938,0.556,0.605 and 0.778,respectively.Delong test showed that the area under ROC curve of FABA and LCS was larger than LTS and MLPS,and the difference was statistically significant(P<0.05).There was no significant difference in the area under ROC curve between FABA and LCS(P>0.05).Conclusion FABA,LTS,LCS and MLPS measured by MRI are independent influence factors for non-contact ACL injury in young males,among which FABA and LCS have higher predictive value for non-contact ACL injury.
作者
罗超然
许尚文
蓝丽敏
胡雅诺
肖慧
LUO Chao-ran;XU Shang-wen;LAN Li-min;HU Ya-nuo;XIAO Hui(Department of Imaging,Mengchao Hepatobiliary Hospital of Fujian Medical University,Fuzhou 350025,China;Department of Radiology,the 900th Hospital of PLA Joint Logistic Support Force,Fuzhou 350025,China)
出处
《创伤与急危重病医学》
2025年第3期189-194,共6页
Trauma and Critical Care Medicine
基金
第九〇〇医院院立课题(2023ZS06)。
关键词
膝关节
前交叉韧带损伤
非接触性
磁共振成像
运动医学
Knee joint
Anterior cruciate ligament injury
Non-contact
Magnetic resonance imaging
Sports medicine
作者简介
第一作者:罗超然(1997-),男,福建龙岩人,硕士;通信作者:肖慧,E-mail:xiaohui855@163.com。
