人体参数和MRI预测腘绳肌肌腱移植物直径的可行性与准确性分析  

Examination in Predicting Hamstring Tendon Autograft Diameter

作　　者：王晓宝 林艺 刘泽宇 于鹏 付昆 Wang Xiaobao;Lin Yi;Liu Zeyu;Yu Peng;Fu Kun(Department of Joint Surgery,The First Affiliated Hospital of Hainan Medical University,Haikou 570100,China)

机构地区：[1]海南医科大学第一附属医院关节外科,海南海口570100

出　　处：《实用骨科杂志》2025年第2期121-125,共5页Journal of Practical Orthopaedics

基　　金：海南省卫生健康科技创新联合项目(WSJK2024MS228)。

摘　　要：目的探讨性别、年龄、手术侧、身高、体重、身体质量指数(body mass index,BMI)等人体参数,以及膝关节MRI预测腘绳肌肌腱移植物直径(final graft diameter,FGD)的可行性及准确性。方法回顾性分析2017年1月至2023年12月海南医科大学第一附属医院采用四股自体腘绳肌肌腱移植物进行前交叉韧带重建手术的61例患者资料,其中男47例,女14例;年龄14~55岁,平均(30.85±11.47)岁。利用线性相关分析、偏相关性分析和逐步多元线性回归分析,明确FGD与预测变量之间的关系。结果相关性分析显示,FGD与身高、性别、年龄、体重、半腱肌肌腱(semitendinosus tendon,ST)横截面积、股薄肌肌腱(gracilis tendon,GT)横截面积以及半腱肌肌腱和股薄肌肌腱(ST-GT)横截面积之和相关(P<0.05),与手术侧、BMI、损伤原因及大腿横截面积无关。逐步多元线性回归分析显示,身高和ST横截面积是预测FGD的最佳组合。偏相关性分析表明,性别、年龄和体重与FGD之间的相关性是身高差异的间接结果。结论人体基本参数和MRI均能可靠预测腘绳肌肌腱移植物直径,联合预测效果更佳。最佳的预测模型为:FGD=1.292+0.034×身高(cm)+0.044×ST横截面积(mm2),该模型为术前评估提供了新的视角,有助于制定更为精确和个性化的手术计划,推荐在临床实践中应用此模型。Objective To investigate the feasibility and accuracy of predicting the final graft diameter(FGD)of hamstring tendon using human body parameters such as gender,age,surgical side,height,weight,and body mass index(BMI),as well as knee MRI.Methods A retrospective analysis was conducted on the data of 61 patients who underwent anterior cruciate ligament(ACL)reconstruction using autologous four-strand hamstring tendon grafts at the First Affiliated Hospital of Hainan Medical University from January 2017 to December 2023.Among them were 47 males and 14 females,with an age range of 14 to 55 years[mean age(30.85±11.47)years].Linear correlation analysis,partial correlation analysis,and stepwise multiple linear regression analysis were employed to determine the relationship between FGD and the predictive variables.Results Correlation analysis showed that FGD was correlated with height,gender,age,weight,cross-sectional area of the semitendinosus tendon(ST CSA),cross-sectional area of the gracilis tendon(GT CSA),and the sum of the cross-sectional areas of the semitendinosus and gracilis tendons(ST-GT CSA)(P<0.05),but not with surgical side,BMI,or thigh cross-sectional area.Stepwise multiple linear regression analysis indicated that height and ST CSA were the best combination for predicting FGD.Partial correlation analysis suggested that the correlations between gender,age,and weight with FGD were indirect results of height differences.Conclusion Basic human parameters and MRI can both reliably predict the diameter of hamstring tendon grafts,with a combined prediction effect being even better.The best predictive model is:FGD=1.292+0.034×height(cm)+0.044×ST CSA(mm 2).This model provides a new perspective for preoperative assessment and aids in the formulation of more precise and personalized surgical plans,and it is recommended for application in clinical practice.

关 键 词：前交叉韧带 腘绳肌肌腱 自体移植物 移植物直径 预测 

分 类 号：R687.4[医药卫生—骨科学]