前交叉韧带损伤后膝关节周围区域骨密度变化的CT定量测量研究

Changes of bone mineral density surrounding the knee joint after anterior cruciate ligament injury by quantitative CT

目的通过CT定量(quantitative computerized tomography,QCT)测量的方法评估前交叉韧带(anterior cruciate ligament,ACL)损伤后膝关节骨质骨密度(bone mineral density,BMD)的变化情况。方法选择50例ACL损伤患者纳入本研究,所有患者`在ACL重建术前接受QCT检查,分别在股骨内髁、股骨外髁、胫骨平台、预期ACL股骨骨道、预期ACL胫骨骨道选取8个感兴趣区,测量所选区域BMD,并与健侧相应区域进行对比。结果与健侧相比,除预期ACL胫骨骨道口远端和近端外,股骨内髁、股骨外髁、胫骨平台内侧、胫骨平台外侧、预期ACL股骨骨道、预期ACL胫骨骨道中点的BMD均下降,差异具有统计学意义(P<0.05)。控制性别与年龄的条件下,仅胫骨平台内侧的BMD变化率与患者受伤时间具有相关性(P<0.05),其余各因素与受伤时间无相关性(P>0.05)。控制受伤时间与性别,BMD变化率与患者年龄无相关性(P>0.05)。结论ACL损伤后膝关节周围区域骨密度均下降,下降程度与受伤时间、年龄及性别等因素无相关性,具体结果可通过CT定量测量显示。

Objective To evaluate the changes of bone mineral density（BMD） in patients with anterior cruciate ligament（ACL） injury using quantitative CT.Methods Fifty patients with ACL injury were included in this study.All patients received QCT examination before ACL reconstruction surgery.Changes of BND in eight regions of interest （ROI） at medial femoral condyle,lateral femoral condyle,tibial plateau,femoral tunnel of ACL and tibial tunnel of ACL were detected and compared with those in healthy sides.Results Except for the distal and proximal of femoral tunnel of ACL,BMD of femoral condyle,lateral femoral condyle,lateral tibial plateau medial tibial plateau,expected ACL femoral bone tunnel,expected ACL tibial bone tunnel midpoint were significantly lower in injury side than those in healthy side （P ＜ 0.05）.Under the control of gender and age,the BMD variation rate only in medial tibial plateau was related with the injury time （P ＜ 0.05）,but the other factors and injury time had no correlation （P ＞ 0.05）.Under the control of injury time and gender,the BMD variation rate was not correlated with age （P ＞ 0.05）.Conclusion After the ACL injury,BMD decrease surrounding the knee,and the decrease has no correlation with the injury time,age and gender,which can be quantitatively measured by CT.