摘要
目的探讨伴有高度轴移现象的前十字韧带（anterior cruciate ligament，ACL）损伤患者前外侧韧带MRI信号异常的发生率。方法对2016年1至6月收治的连续164例急性ACL损伤患者进行回顾性分析，临床诊断为完全性ACL损伤，受伤机制为非接触性损伤，患者术前均有全面的体格检查及膝关节MRI检查结果。依据术前麻醉下轴移试验检查结果进行分组。轴移试验结果为高度轴移的患者68例，按性别及年龄1：1匹配低度轴移患者68例。比较两组患者MRI冠状面T2WI像上前外侧韧带Ⅰ级扭伤、Ⅱ级部分撕裂及Ⅲ级完全撕裂的发生率。结果高度轴移组与低度轴移组患者平均年龄均为29.3岁，每组各有男性患者43例、女性患者25例。两组患者受伤至手术时间、体重指数及KT-1000侧-侧差值的差异均无统计学意义。两组共105例出现前外侧韧带MRI信号异常，总体发生率为77．2％（105／136）。高度轴移组患者前外侧韧带信号异常发生率为94．1％（64／68），高于低度轴移组的60.3％（41／68），差异有统计学意义（x^2=10．786，P=0．013）。高度轴移组分别有15例、19例、30例发生Ⅰ级扭伤、Ⅱ级部分撕裂及Ⅲ级完全撕裂，低度轴移组分别有29例、8例、4例发生Ⅰ级扭伤、Ⅱ级部分撕裂及Ⅲ级完全撕裂。高度轴移组前外侧韧带撕裂（MRI信号Ⅱ级或Ⅲ级）的发生率为76．6％（49／64），高于低度轴移组的29．3％（12／41），差异有统计学意义（x^2=18．452，P=0．009）。结论伴有高度轴移现象的ACL损伤患者大多存在前外侧韧带MRI信号异常。高度轴移与低度轴移的ACL损伤患者前外侧韧带信号异常的发生率存在明显差异，高度轴移现象可能是ACL合并前外侧韧带损伤的结果。
Objective To investigate the incidence of concomitant anterolateral ligament （ALL） abnormality by magnetic resonance imaging （MRI） on patients with high-grade pivot-shift after anterior cruciate ligament （ACL） injuries. Methods From January 2016 to June 2016, one hundred and sixty-four consecutive patients with acute ACL injury were retrospectively reviewed. All patients underwent comprehensive pre-operative physical examinations and MRI scans. Sixty-eight patients with acute ACL injury who showed high-grade （grade Ⅱ and Ⅲ） pivot-shift phenomenon were enrolled in the high-grade pivot-shift group. They were matched in a 1 ： 1 fashion to another 68 ACL-injured participants who showed low-grade （grade 0 and Ⅰ） pivot-shift phenomenon during the same study period. The grade of ALL injury was divided into grade I （sprain）, grade Ⅱ （partial tear） and grade Ⅲ （com- plete tear）, and they were further compared between the high-grade pivot-shift group and the low-grade pivot-shift group on the coronal view of their T2WI MRI scans. Results The mean age of the patients in all groups was 29.3 years old. There were 43 male and 25 female patients in each group. There were no significant differences in terms of the time from injury to surgery, the body mass index and the KT-1000 side-to-side difference. Overall, there were 105 patients （77.2%, 105/136） showed abnormal signal of the anterolateral ligament on MRI scans. The incidence of concomitant ALL injury in the high-grade pivot-shift group （94.1%, 64/68） was significantly higher than that in the low-grade pivot-shift group （60.3%, 41/68, ~2=10.786, P=0.013）. Specifically, there were 15, 19 and 30 patients who showed grade Ⅰ, Ⅱ and Ⅲ ALL abnormality in high-grade pivot-shift group. However, there were only 29, 8 and 4 patients who showed grade Ⅰ, Ⅱ and Ⅲ ALL abnormality in low-grade pivot-shift group. The incidence of patients who showed grade Ⅱ/Ⅲ MRI evidence of concomitant ALL injury was 76.6% （49/64）
作者
宋关阳
张辉
刘心
吴关
薛喆
冯华
Song Guanyang, Zhang Hui, Liu Xin, Wu Guan, Xue Zhe, Feng Hua(Sports Medicine Service, Beijing Jishuitan Hospital, Bering 100035, China （Song GY, Zhang H, Liu X, Wu G, Xue Z, Feng H）)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2018年第7期385-389,共5页
Chinese Journal of Orthopaedics
基金
国家自然科学基金（81572153）
关键词
前交叉韧带
膝损伤
磁共振成像
Anterior cruciate ligament： Knee injuries： Magnetic resonance imaging
