应力X线测量在诊断膝关节前交叉韧带损伤中的价值

Diagnostic value of lateral x-ray examination with knee joint in anterior cruciate ligament injury

目的探讨X线测量在膝关节前交叉韧带(ACL)损伤诊断中的价值。方法对68例单纯、单侧的膝关节ACL损伤患者进行双膝关节侧位片进行相关数据测量,对比分析患、健侧所测数据的差异。结果 (1)屈膝位前抽屉试验时健侧平台应力前移度AO/AP为(52.68±6.24)%,患侧平台应力前移度AO/AP为(63.01±5.92)%,双侧屈膝平台应力前移度比较差异有统计学意义(P<0.05);伸膝应力位顶-平台相交率健侧为(23.15±5.02)%,患侧为(32.34±4.86)%,双侧比较差异有统计学意义(P<0.05);顶-平台角健侧为(55.13±7.20)°,患侧为(60.46±6.73)°,双侧比较差异有统计学意义(P<0.05);而股骨-平台夹角健侧为(97.49±2.41)°,患侧为(99.05±2.59)°,双侧比较差异无统计学意义(P>0.05);(2)与伤后3个月内就诊相比,伤后超过3个月就诊的患膝平台应力前移度、伸膝应力位顶-平台相交率及顶-平台角比较差异有统计学意义(P<0.05);而伸膝应力位股骨-平台夹角比较差异无统计学意义(P>0.05)。结论 X线测量在诊断膝关节ACL损伤中具有明显的诊断价值,在膝关节侧位片上,ACL损伤侧膝关节屈膝位前抽屉试验时平台应力前移度、伸膝应力位的顶-平台相交率和顶-平台角均高于健侧膝,且受伤时间越长上述变化越明显。X线测量可作为ACL损伤的常规检查及诊断依据推广应用。

Objective To investigate the diagnostic value of lateral X-ray examination with knee joint in anterior cruciate ligament injury.Methods 68 patients with simple and unilateral ACL injury were enrolled in lateral x-ray radiography with bilateral knees at bending and extending position.Then compared the differences between normal and injury joints.Results（1）The value of AO/AP of knee joint at bending position in anterior drawer test,the intersectant rate of roof-plateau and roof-plateau angle of knee joint at extending stress position in the normal knee were（52.68±6.24）%,（23.15±5.02）% and（55.13±7.20）°,they were（63.01±5.92）%,（32.34±4.86）% and（60.46±6.73）°in the knee with ACL injury respectively,there were significant difference between bilateral knees（P＆lt;0.05）.The femur-plateau angle in the normal knee and the knee with ACL injury were（97.49±2.41）°and（99.05±2.59）°respectively,there was no significant difference between them（P＆gt;0.05）.（2）The value of AO/AP at bending position,intersectant rate of roof-plateau and roof-plateau angle at extending stress position of injury knee joints in three months had significant difference compared with injury knee joints after three months.Conclusion Lateral X-ray examination with knee at bending and extending position is an effective method in the diagnosis of anterior cruciate ligament injury and more obviously with increasing injury time.It can be used as a routine method because of low cost and convenience.