摘要
目的:探究膝关节前交叉韧带(anterior cruciate ligament,ACL)急性损伤后出现过度胫骨前移(anterior tibial translation,ATT)的危险因素。方法:回顾性分析自2017年1月至2019年6月在我科因急性ACL损伤行ACL重建术的患者资料,资料完整且符合纳入及排除标准的共计141例患者被纳入本研究,其中男性106例、女性35例。在下肢负重位全长X线片上测量胫骨前移,ATT≥6 mm定义为过度胫骨前移,该组患者为病例组,ATT<6 mm的患者归入对照组。首先采用单因素分析比较两组间年龄、性别、体质指数(body mass index,BMI)、受伤至手术时间、半月板损伤、胫骨平台后倾角及体格检查结果是否存在显著性差异,然后采用多因素Logistic回归分析确定前交叉韧带损伤后出现过度胫骨前移的危险因素。结果:ATT≥6 mm的患者77例为病例组,ATT<6 mm的患者64例为对照组。单因素分析结果显示两组间轴移试验及胫骨平台后倾角存在显著差异,多因素logistic回归分析进一步确认异常增大的胫骨平台后倾角(PTS≥17°)(OR=4.22,P<0.001)和高度轴移(OR=2.46,P=0.037)是急性前交叉韧带损伤后ATT≥6 mm的独立危险因素;而半月板损伤、年龄、性别、BMI等与ATT之间无显著相关性。结论:急性前交叉韧带损伤后,PTS≥17°和高度轴移是ATT≥6 mm的独立危险因素。
ObjectiveTo explore the risk factors of excessive anterior tibial translation(ATT)after acute anterior cruciate ligament(ACL)injury.MethodsPatients undergoing ACL reconstruction after ACL acute injury between January 2017 and June 2019 was retrospectively reviewed.According to the included and excluded criteria,141 patients were enrolled,including 106 males and 35 females.The ATT was measured on the weightbearing whole leg radiographs.ATT≥6 mm was defined as excessive anterior tibial translation.Those patients with ATT≥6 mm were selected into the study group,while those with ATT<6 mm were chosen into the control group.The age,gender,body mass index(BMI),time gap between injury and surgery,meniscal lesions,posterior tibial slope(PTS),and the results of physical examination were compared between the two groups using the univariate analysis.Moreover,the risk factors of the excessive ATT were assessed using the multivariable logistic regression analysis.ResultsSeventy-seven patients with ATT≥6 mm were enrolled in the study group,and another 64 with ATT<6 mm were enrolled as the control group.The univariate analysis results showed that significant differences were observed between the two groups in the pivot shift and posterior tibial slope,while the multivariable logistic regressions indicated that abnormal increase of PTS(≥17°)(OR=4.22,P<0.001)and high-grade pivot shift(OR=2.46,P=0.037)were independent risk factors of ATT≥6 mm after acute ACL injury.However,meniscal lesions,age,gender and BMI were not.Conclusion PTS≥17°and high-grade pivot shift are independent risk factors of ATT≥6 mm after acute ACL injury.
作者
倪乾坤
张辉
宋关阳
张志军
郑峒
冯峥
曹晏维
冯华
Ni Qiankun;Zhang Hui;Song Guanyang;Zhang Zhijun;Zheng Tong;Feng Zheng;Cao Yanwei;Feng Hua(Department of Sports Medicine,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2019年第12期1015-1020,共6页
Chinese Journal of Sports Medicine
基金
北京市医院管理局“登峰”计划专项经费资助(DFL20180402)
国家自然科学基金面上项目(81572153)
北京市科学技术委员会资助课题(Z181100001718106).
关键词
急性前交叉韧带损伤
胫骨平台后倾角
高度轴移
负重位胫骨前移
危险因素
acute anterior cruciate ligament injury
posterior tibial slope
high-grade pivot shift
weightbearing anterior tibial translation
risk factor
