中医康复2025，Vol.2Issue(7)：14-20,7.DOI:10.19787/j.issn.2097-3128.2025.07.003
陈旧性前交叉韧带损伤后膝关节旋转不稳定性的膝关节相关解剖参数影响研究
A Study on the Influence of Knee-Related Anatomical Parameters on Knee Rotational Insta-bility after Obsolete Anterior Cruciate Ligament Injury
摘要
Abstract
Objective:The purpose of this retrospective study is to measure changes in posterior tibial slopes(PTS),meniscus slopes(MS),slopes of the meniscus posterior horn(SMPH),and posterior cruciate ligament indices(PCLI)of the knee in obsolete anterior cruciate ligament injuries(ACL)based on magnetic resonance imaging(MRI)data,and to investigate their correlation with rota-tional instability of the knee after ACL injury.Methods:A retrospective analysis of 154 medical records with ACL injuries or normal ACLs was performed,which were categorized according to ACL injuries into three groups:normal group,injure ACL,rupture ACL.Knee MRI data including PTS,MS,SMPH and PCLI were collected from all patients,as well as the grade of the pivot-shift test from all patients,and rotational stability of the knee was assessed based on the results of the pivot-shift test.In addition,the correla-tion between these indices and the incidence of rotational instability was assessed using binary logistic regression analysis.Results:Comparison of baseline data among the three groups was not statistically significant(P=0.792,0.801,0.106,and 0.642);The medial and lateral PTS,MS,and PCLI were significantly higher than those of the normal group,and the medial and lateral SMPH were smaller than those of the normal group in the ACL injury group and the rupture group(P<0.001);All parameters except the lateral MS were significantly different from the normal group in both ACL-injured groups(P<0.001);Comparing the two ACL-injured groups,there was statistical significance only in the medial MS and PCLI(P=0.047,0.009);The results of the pxial-shift test showed that the number of people with high pxial-shift phenomenon in the ACL injury group,rupture group,and normal group was 15,33,and 1 cases,respectively,and the difference was statistically significant when comparing among the three groups(P<0.05);Logistic regression analysis showed that lateral PTS was positively correlated with the occurrence of rotational instability(OR:7.836,95%CL:1.711～35.877,P=0.008)and lateral SMPH was negatively correlated(OR:0.813,95%CL:0.681～0.970,P=0.021).Conclu-sions:Obsolete ACL injuries are prone to rotational instability of the knee,and based on MRI measurements and analysis of anatomi-cal parameters associated with deterioration of stability,excessive posterior tilt of the lateral tibial plateau and reduced SMPH due to posterior horn tear of the lateral meniscus were found to be associated with it.Therefore,when diagnosing obsolete ACL injuries and considering ligament reconstruction treatment,the impact of rotational instability of the knee on treatment should be particularly em-phasized in patients with a lateral PTS>9°and a lateral SMPH<28°.关键词
陈旧性前交叉韧带损伤/胫骨平台后倾角/半月板后倾角/半月板后角倾斜度/后交叉韧带指数/旋转不稳定/轴移试验/相关性Key words
obsolete anterior cruciate ligament injury/posterior tibial slope/meniscus slopes/slopes of meniscus posterior horn/posterior cruciate ligament indices/rotational instability/pivot-shift test/correlation分类
临床医学引用本文复制引用
窦世鲁,于希名,路聊东,王猛,李中峰,王东伟..陈旧性前交叉韧带损伤后膝关节旋转不稳定性的膝关节相关解剖参数影响研究[J].中医康复,2025,2(7):14-20,7.基金项目
山东省中医药科技发展计划项目(M-2023270) （M-2023270）
山东省老年医学学会科技攻关项目(LKJGG2024W071) （LKJGG2024W071）
