前交叉韧带损伤与胫骨平台后侧骨损伤的相关性分析

Correlation analysis between anterior cruciate ligament injury and posterior tibial plateau bone injury

目的探讨前交叉韧带(anterior cruciate ligament,ACL)损伤与胫骨平台后侧骨损伤的相关性。方法纳入我院2010年10月至2017年10月行膝关节MRI的门诊或住院病人581例,年龄为(45.72±11.38)岁(20~79岁);男362例,女219例。分析所有病人的膝关节MRI影像学资料,记录病人ACL损伤程度(轻度损伤/断裂/撕脱骨折)、胫骨平台后侧骨损伤程度(骨挫伤/骨折),以及股骨损伤、半月板和侧副韧带损伤情况,并分析其致伤原因。采用Spearman秩相关分析病人ACL损伤与胫骨平台骨损伤之间的关系,并分析可能的损伤机制。结果581例病人中,ACL轻度损伤440例(75.73%),ACL断裂122例(21.00%),ACL撕脱骨折19例(3.27%)。202例出现胫骨平台后侧骨挫伤,47例出现胫骨平台后侧骨折;152例(61.04%)发生在外侧平台,59例(23.69%)发生在内侧平台,38例(15.26%)发生在双侧平台。Spearman秩相关分析结果显示ACL损伤程度与胫骨平台后侧骨损伤程度呈正相关(r=0.344,P<0.0001)。结论随着ACL损伤程度增加,胫骨平台后侧骨损伤越重,且以胫骨平台后外侧骨损伤为主。

Objective To explore the relationship between anterior cruciate ligament(ACL)injuries and posterior tibial plateau bone injury.Methods From October 2010 to October 2017,581 inpatients or outpatients who performed knee joint magnetic resonance imaging(MRI)were enrolled in this study,The age was(45.72±11.38)years old(ranging from 20 to 79),and there were 362 males,and 219 females.The ACL injury,posterior tibial plateau bone injury,femoral injury,meniscal and collateral ligament injury and injury causation were recorded by analyzing the knee joint MRI data of all patients.The relationship between ACL injury and posterior tibial plateau bone injury was analyzed by Spearman’s rank correlation.And possible damage mechanisms were studied.Results Of 581 patients,there were 440 cases(75.73%)of ACL mild injury,122 cases(21.00%)of ACL rupture,and 19 cases(3.27%)of ACL.There were 202 cases of posterior tibial plateau bone bruise,and 47 cases of posterior tibial plateau fracture,of which the posterior tibial plateau injuries were located in lateral tibial plateau of 152 cases(61.04%),in medial tibial plateau of 59 cases(23.69%),and in bilateral tibial plateau of 38 cases(15.26%)respectively.The result of Spearman’s rank correlation analysis demonstrated that there was positive correlation between ACL injury and posterior tibial plateau bone injury(r=0.344,P<0.0001),and the degree of posterior tibial plateau bone damage was aggravated as ACL damage increased.Conclusion There is positive correlation between ACL damage and posterior tibial plateau bone damage,mainly on the lateral side.