急性非接触性前交叉韧带撕裂后关节伴随损伤的性别差异

Concomitant articular injuries in acute noncontact anterior cruciate ligament tears: a comparison of gender difference

目的对比分析急性非接触性前交叉韧带(ACL)撕裂后关节伴随损伤男女性别组间的不同点。方法回顾性分析193例经临床证实为急性非接触性ACL撕裂患者的MRI资料,其中男性112例,女性81例,对男女性别组的膝关节伴随损伤情况分类统计并进行统计学分析。结果在112例男性病例中,发现骨挫伤107例(95.5%),其中联合间室骨挫伤32例,外侧间室骨挫伤70例,内侧间室骨挫伤5例;81例女性病例中,发现骨挫伤72例(88.9%),其中联合间室骨挫伤16例,外侧间室骨挫伤49例,内侧间室骨挫伤7例;两组比较,联合间室骨挫伤发生率差异有统计学意义(χ^(2)=4.315,P=0.038)。男女组伴发内外侧半月板(MM、LM)损伤发生率分别为(33.9%、46.4%)和(25.9%、32.1%),两组比较,LM损伤发生率差异有统计学意义(χ^(2)=4.008,P=0.045)。男女组伴发内、外侧副韧带损伤发生率分别为(20.5%、7.1%)和(18.5%、3.7%),两组比较,差异均无统计学意义。男女组伴发关节软骨损伤发生率为17.9%和7.4%,两组比较,差异有统计学意义(χ^(2)=4.403,P=0.036)。结论男性患者较女性患者在急性非接触性ACL撕裂后更易伴发联合间室骨挫伤、LM损伤和关节软骨损伤。

Objective To explore the gender difference in concomitant articular injuries after acute noncontact anterior cruciate ligament(ACL)tears.Methods The MRI data of 193 patients with clinically proved acute noncontact ACL tears was retrospectively analyzed.The subjects included 112 males and 81 females.The concomitant injuries of knee joints in the male group and female group were categorized and statistically analyzed.Results A total of 107 cases(95.5%)of bone bruises were observed among the 112 males.Thirty-two of these cases were in the medial and lateral compartments of knees(combined compartments),70 cases in the lateral compartment,and 5 in the medial compartment.Bone bruises were observed in 72(88.9%)of the 81 females.Sixteen cases of bone bruise were in the medial and lateral compartments of knees(combined compartments),49 cases in the lateral compartment,and 7 in the medial compartment.There was statistically significant difference in the incidence of bone bruises in the combined compartments between the two groups(χ^(2)=4.315,P=0.038).The incidence of medial and lateral meniscus injuries in the male group and female group was(33.9%,46.4%)and(25.9%,32.1%),respectively.The difference in the incidence of lateral meniscus injuries was statistically significant between the two groups(χ^(2)=4.008,P=0.045).The incidence of medial and lateral collateral ligament injuries in the male and female groups was(20.5%,7.1%)and(18.5%,3.7%),respectively,so there was no statistically significant difference between the two groups.The incidence of articular cartilage injuries in male and female groups was 17.9%and 7.4%,respectively.There was statistically significant difference between the two groups(χ^(2)=4.403,P=0.036).Conclusions Male patients with acute noncontact ACL tears are more vulnerable to concomitant bone bruises in the combined compartments,LM injuries,and articular cartilage lesions than their female counterparts.