基于CT分析膝关节前外侧韧带损伤的股骨后髁形态特征

Morphological characteristics of posterior femoral condyle of knee anterolateral ligament injury based on CT findings

目的基于CT图像定量测量并分析膝关节前外侧韧带(anterolateral ligament, ALL)损伤的股骨后髁形态特征。方法回顾性筛选2014年1月至2019年4月本院41例急性ALL损伤的膝关节作为损伤组,并匹配41例膝关节作为对照组。受试者均有膝关节完整的影像资料,利用其CT图像定量测量两组的膝关节形态学参数,包括髁总宽度(medial-lateral width of epicondyle, MLW)、内侧后髁宽度(medial posterior condyle width, MPCW)、外侧后髁宽度(lateral posterior condyle width, LPCW)、外侧髁长度(lateral condyle length, LCL)、内侧髁长度(medial condyle length, MCL)、外侧后髁长度(lateral posterior condyle length, LPCL)、内侧后髁长度(medial posterior condyle length, MPCL)、内侧后髁高度(medial posterior condyle height, MPCH)、外侧后髁高度(lateral posterior condyle heigh, LPCH)。另计算后髁宽度(LPCW/MLW、MPCW/MLW)和长度(LPCL/LCL、MPCL/MCL)比值使得个体差异最小化。统计分析两组各参数之间的差异。结果两组间后髁形态差异具有统计学意义(P<0.05)。(1)宽度:ALL损伤组MLW大于对照组(P=0.042),LPCW/MLW和MPCW/MLW低于对照组(P<0.05);(2)长度:ALL损伤组MCL、MPCL和LCL大于对照组(P<0.05),LPCL/LCL低于对照组(P<0.01);(3)高度:两组间内、外侧后髁高度的差异均无统计学意义。结论 ALL损伤组的内侧股骨后髁更窄,外侧股骨后髁更窄更短,可能通过改变膝关节的内部运动而增加ALL损伤的风险。

Objective To quantitatively measure and analyze the morphological features of posterior femoral condyle of anterolateral ligament(ALL)injury based on CT images.Methods A total of 41 knees with acute ALL injuries admitted in our hospital from January 2014 to April 2019 were retrospectively selected as the injury group,and the other 41 matched knee joints served as the control group.Their complete imaging data of the knee joints were collected,and the CT images were used to quantitatively measure the morphological parameters of knee joints in the 2 groups,including medial-lateral width of epicondyle(MLW),medial posterior condyle width(MPCW),and lateral posterior condyle width(LPCW),lateral condyle length(LCL),medial condyle length(MCL),lateral posterior condyle length(LPCL),medial posterior condyle length(MPCL),medial posterior condyle height(MPCH),and lateral posterior condyle height(LPCH).In addition,the ratios of posterior condyle widths(LPCW/MLW,MPCW/MLW)and those of lengths(LPCL/LCL,MPCL/MCL)was calculated to minimize individual differences.Statistical analysis was carried out for the differences of parameters between the 2 groups.Results The differences in width and length of posterior condyle between the 2 groups were statistically significant(P<0.05).(1)Width:MLW was greater(P=0.042),and the ratios of LPCW/MLW and MPCW/MLW were significantly lower in the ALL injury group than the control group(P<0.05);(2)Length:MCL,MPCL and LCL were larger(P<0.05)and the ratio of LPCL/LCL was lower in ALL injury group than the control group(P<0.01);(3)Height:There was no statistical difference in the height of medial and lateral posterior condyles between the 2 groups(P>0.05).Conclusion The medial posterior femoral condyle is narrower,and the lateral posterior femoral condyle is narrower and shorter.And shorter lateral posterior condyle increases the risk of ALL injury by changing the internal movement of knee joints.