Wang Jingyu,Yuan Liang,Lin Xiaohui,et al.Effect of tibiofemoral joint morphology evaluated by magnetic resonance imaging on the tear of anterior cruciate ligament[J].Journal of Chongqing Medical University,2024,49(8):1058-1064.
Wang Jingyu,Yuan Liang,Lin Xiaohui,et al.Effect of tibiofemoral joint morphology evaluated by magnetic resonance imaging on the tear of anterior cruciate ligament[J].Journal of Chongqing Medical University,2024,49(8):1058-1064. DOI: 10.13406/j.cnki.cyxb.003569.
Effect of tibiofemoral joint morphology evaluated by magnetic resonance imaging on the tear of anterior cruciate ligament
0.05);ROC曲线显示,MCL/MPL、NWI及联合模型对ACL撕裂具有一定的预测价值,曲线下面积(area under curve,AUC)分别为0.672、0.671、0.734;③2组患者NW、INH、MCW、LCW、LCL、LPW、LPL、MCW/LCW、MPW/LPW、MCW/MPW、LCW/LPW、LCL/LPL、INA/IEA、IEA、MPA、LPA比较差异无统计学意义(
P
>
0.05)。
结论
2
胫股关节形态与ACL撕裂具有相关性;MCL/MPL越大,NWI越小,ACL撕裂的危险程度越高。
Abstract
Objective
2
To investigate the correlation between tibiofemoral joint morphology and the tear of anterior cruciate ligament(ACL)based on knee joint magnetic resonance imaging(MRI).
Methods
2
Among the patients who underwent knee joint MRI in The First Affiliated Hospital of Chongqing Medical University from January 1,2018 to January 31,2023,81 patients with complete ACL tear were enrolled as case group,and 82 patients with normal ACL were enrolled as control group. The two groups were compared in terms of the anatomical parameters of the femur and tibia,including intercondylar notch height(INH),intercondylar notch width(INW),notch width(NW),intercondylar notch angle(INA),medial condyle width(MCW),medial condyle length(MCL),lateral condyle width(LCW),lateral condyle length(LCL),medial tibial plateau width(MPW),medial tibial plateau length(MPL),lateral tibial plateau width(LPW),lateral tibial plateau length(LPL),intercondylar eminence angle(IEA),medial tibial plateau angle(MPA),and lateral tibial plateau angle(LPA),and intercondylar notch width index(NWI)was calculated. MCW/LCW,MCL/LCL,MPW/LPW,and MPL/LPL ratios were used to describe the relative differences in bone morphology of the medial and lateral sides of the femur and tibia,and MCL/MPL,LCW/LPW,LCW/LPW,LCL/LPL,and INA/IEA ratios were used to describe the consistency of the tibiofemoral joint. The univariate and multivariate logistic analyses were performed for the two groups,and a logistic joint model was established based on the independent risk factors obtained. A receiver operating characteristic(ROC)curve analysis was also performed.
Results
2
Compared with the control group,the case group had significantly lower INW,NWI,INA,and MCL/MPL ratio(
0.05). The multivariate analysis showed that MCL/MPL ratio and NWI were independent risk factors for ACL tear(
P
<
0.05). The ROC curve analysis showed that MCL/MPL ratio,NWI and joint model had a certain value in predicting ACL tear,with an area under the ROC curve of 0.672,0.671 and 0.734,respectively. There were no significant differences between the two groups in NW,INH,MCW,LCW,LCL,LPW,LPL,MCW/LCW ratio,MPW/LPW ratio,MCW/MPW ratio,LCW/LPW ratio,LCL/LPL ratio,INA/IEA ratio,IEA,MPA,and LPA(
P
>
0.05).
Conclusion
2
The morphology of the tibiofemoral joint is associated with ACL tear,and the risk of ACL increases with the increase in MCL/MPL ratio and the reduction in NWI.
关键词
Keywords
references
Bayer S , Meredith SJ , Wilson KW , et al . Knee morphological risk factors for anterior cruciate ligament injury:a systematic review [J ] . J Bone Joint Surg Am , 2020 , 102 ( 8 ): 703 - 718 .
Wilson WT , Hopper GP , Banger MS , et al . Anterior cruciate ligament repair with internal brace augmentation:a systematic review [J ] . Knee , 2022 , 35 : 192 - 200 .
Arumugam A , Björklund M , Mikko S , et al . Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury:a systematic review and GRADE evidence synthesis [J ] . BMJ Open , 2021 , 11 ( 5 ): e049226 .
Lansdown D , Ma CB . The influence of tibial and femoral bone morphology on knee kinematics in the anterior cruciate ligament injured knee [J ] . Clin Sports Med , 2018 , 37 ( 1 ): 127 - 136 .
Al-Saeed O , Brown M , Athyal R , et al . Association of femoral intercondylar Notch morphology,width index and the risk of anterior cruciate ligament injury [J ] . Knee Surg Sports Traumatol Arthrosc , 2013 , 21 ( 3 ): 678 - 682 .
Jagadeesh N , Paidipati R , Parameshwar A , et al . Correlation of tibial parameters like medial,lateral posterior tibial slope and medial plateau depth with ACL injuries:randomized control study [J ] . Eur J Orthop Surg Traumatol , 2023 , 33 ( 4 ): 1267 - 1274 .
Zhang W , Liu YP , Wang XL , et al . Imaging analysis of risk factors for knee anterior cruciate ligament injury [J ] . Chin J Tissue Eng Res , 2022 , 26 ( 15 ): 2361 - 2366 .
Wu FB , Colak C , Subhas N . Preoperative and postoperative magnetic resonance imaging of the cruciate ligaments [J ] . Magn Reson Imaging Clin N Am , 2022 , 30 ( 2 ): 261 - 275 .
Fan N , Zang L , Zheng YC , et al . The correlation between posterior cruciate ligament avulsion fracture and intercondylar Notch and tibial slope [J ] . Chin J Orthop , 2020 , 40 ( 17 ): 1197 - 1205 .
Cay N , Acar HI , Dogan M , et al . Radiological evaluation of femoral intercondylar Notch and tibial intercondylar eminence morphometries in anterior cruciate ligament pathologies using magnetic resonance imaging [J ] . Indian J Orthop , 2022 , 56 ( 2 ): 327 - 337 .
Musahl V , Ayeni OR , Citak M , et al . The influence of bony morphology on the magnitude of the pivot shift [J ] . Knee Surg Sports Traumatol Arthrosc , 2010 , 18 ( 9 ): 1232 - 1238 .
Zhu Y , Shu Q , Yu DW , et al . Relationship between proprioception and anterior cruciate ligament injury based on neuromuscular control theory [J ] . West China Med J , 2022 , 37 ( 5 ): 688 - 692 .
Zhu Y , Shu Q , Yu DW , et al . Relationship between proprioception and anterior cruciate ligament injury based on neuromuscular control theory [J ] . West China Med J , 2022 , 8 ( 5 ): 688 - 692 .
Jha V , Pandit A . Notch volume measured on magnetic resonance imaging is better than 2-dimensional Notch parameters for predicting noncontact anterior cruciate ligament injury in males [J ] . Arthroscopy , 2021 , 37 ( 5 ): 1534 - 1543 .
Wilson WT , Hopper GP , O’Boyle M , et al . Quantifying graft impingement in anterior cruciate ligament reconstruction [J ] . Knee , 2022 , 34 : 270 - 278 .
Muneta T , Takakuda K , Yamamoto H . Intercondylar Notch width and its relation to the configuration and cross-sectional area of the anterior cruciate ligament. A cadaveric knee study [J ] . Am J Sports Med , 1997 , 25 ( 1 ): 69 - 72 .
Kızılgöz V , Sivrioğlu AK , Ulusoy GR , et al . Analysis of the risk factors for anterior cruciate ligament injury:an investigation of structural tendencies [J ] . Clin Imaging , 2018 , 50 : 20 - 30 .
Pradhan P , Kaushal SG , Kocher MS , et al . Development of anatomic risk factors for ACL injuries:a comparison between ACL-injured knees and matched controls [J ] . Am J Sports Med , 2023 , 51 ( 9 ): 2267 - 2274 .
Fu CX , Fan XG , Jiang SG , et al . Increased lateral and medial femoral posterior radius ratios are risk factors for anterior cruciate ligament injury [J ] . BMC Musculoskelet Disord , 2022 , 23 ( 1 ): 114 .
Stockton DJ , Schmidt AM , Yung A , et al . Tibiofemoral contact and alignment in patients with anterior cruciate ligament rupture treated nonoperatively versus reconstruction:an upright,open MRI study [J ] . Bone Joint J , 2021 , 103 -B( 9 ): 1505 - 1513 .