MRI评价成人前交叉韧带损伤与髌骨高位及股骨滑车发育不良的关系  

Correlation of anterior cruciate ligament injury with patella alta and femoral trochlear dysplasia in adults evaluated by magnetic resonance imaging

作　　者：曾维鹏 林坚平[1] 周钢[1] 毛汉儒 Zeng Weipeng;Lin Jianping;Zhou Gang;Mao Hanru(Department of Joint Surgery,Hainan Provincial People’s Hospital(Hainan Hospital Affiliated to Hainan Medical College),Haikou 570100,Hainan Province,China)

机构地区：[1]海南省人民医院(海南医学院附属海南医院)关节外科,海南省海口市570100

出　　处：《中国组织工程研究》2023年第13期2071-2075,共5页Chinese Journal of Tissue Engineering Research

基　　金：海南省重点研发计划项目(ZDYF2017112),项目负责人:林坚平。

摘　　要：背景:前交叉韧带损伤是年轻人群中常见的运动伤,膝关节的解剖学因素可能与其损伤相关,但很少有学者采用MRI评估前交叉韧带损伤与髌骨高位及股骨滑车发育不良之间的关系。目的:探究成人前交叉韧带损伤是否与髌骨高位和滑车发育不良之间的相关性。方法:选择2017年8月至2021年8月海南省人民医院(海南医学院附属海南医院)关节外科收治的90例完全性前交叉韧带撕裂成年患者(病例组)进行回顾性分析;根据年龄和性别匹配91例因膝关节疼痛就诊的患者作为对照组。根据膝关节MRI图像,测量髌腱和髌骨长度,并计算Insall-Salvati指数(ISI值)。根据Dejour分型将股骨滑车发育不良分为A、B、C或D型。结果与结论:①两组髌骨长度差异无显著性意义(P>0.05),但髌腱长度和ISI值差异有显著性意义(P<0.05);②相比对照组,病例组患者的髌腱较长(P<0.05),ISI值较大(P<0.05);③病例组股骨滑车发育不良率(14%)显著高于对照组(4%),差异有显著性意义(P<0.05);④在病例组13例股骨滑车发育不良患者中,A型9例,B型2例,C型1例,D型1例;⑤提示相比前交叉韧带正常人群,前交叉韧带损伤患者具有较长的髌腱长度、较高的ISI值和股骨滑车发育不良率;因此临床中医生应该关注这些变异可能是前交叉韧带撕裂的危险因素,并提醒患有髌骨高位和股骨滑车发育不良人群在运动中更容易损伤前交叉韧带。BACKGROUND:Anterior cruciate ligament injury is a common sports injury in young people.Anatomical factors of the knee joint may be related to its injury,but few scholars have used MRI to evaluate the relationship of anterior cruciate ligament injury with patella alta and femoral trochlear dysplasia.OBJECTIVE:To explore whether there is a correlation of anterior cruciate ligament injury with patella alta and femoral trochlear dysplasia in adults.METHODS:From August 2017 to August 2021,90 adult patients(case group)with complete anterior cruciate ligament tear were retrospectively analyzed.According to age and gender,91 patients with knee pain were matched as the control group.The length of the patellar tendon and patella was measured and the Insall-Salvati index was calculated according to the MRI image of the knee.According to Dejour classification,the femoral trochlear dysplasia was classified into types A,B,C or D.RESULTS AND CONCLUSION:(1)There was no significant difference in patellar length between the two groups(P>0.05),but there was statistically significant difference in the length of patellar tendon and Insall-Salvati index(P<0.05).(2)Compared with the control group,patients in the case group had a longer length of patellar tendon(P<0.05)and higher Insall-Salvati index(P<0.05).(3)The rate of femoral trochlear dysplasia in the case group(14%)was significantly higher than that of the control group(4%,P<0.05).(4)Among the 13 patients with trochlear dysplasia in the case group,9 were type A,2 were type B,1 was type C,and 1 was type D.(5)It is concluded that compared with healthy people,patients with anterior cruciate ligament injury have longer length of patellar tendon,higher Insall-Salvati index and higher rate of trochlear dysplasia.Therefore,in clinical practice,doctors should pay attention to these variants that may be risk factors for anterior cruciate ligament tears,and remind people with patella alta and trochlear dysplasia that they are more likely to damage the anterior cruciate ligament during exer

关 键 词：前交叉韧带 前交叉韧带撕裂 髌骨高位 滑车发育不良 磁共振成像 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R445