陈旧性前交叉韧带损伤伴发内侧半月板撕裂的影响因素分析

Analysis of influencing factors of old anterior cruciate ligament injury with medial meniscus tear

目的分析陈旧性前交叉韧带(ACL)损伤伴发内侧半月板撕裂的影响因素。方法回顾性分析2018年9月至2021年10月常德市第一中医医院200例陈旧性ACL损伤患者临床资料,根据患者是否伴发内侧半月板撕裂分为研究组(伴发内侧半月板撕裂)与对照组(内侧半月板正常),每组各100例。所有患者均通过磁共振成像扫描测量膝关节解剖学参数(膝关节内翻角度、ACL胫骨止点宽度、内侧胫骨平台后倾角、胫骨冠状倾斜角、内侧胫骨平台深度)。比较两组患者膝关节解剖学参数,采用logistic回归模型分析内侧半月板撕裂的影响因素。结果研究组患者的膝关节内翻角、内侧胫骨平台后倾角、胫骨冠状倾斜角大于对照组,ACL胫骨止点宽度、内侧胫骨平台深度小于对照组,差异均有统计学意义(P<0.05);多因素logistic分析显示,内侧胫骨平台深度减小(OR=1.152)、胫骨冠状倾斜角增大(OR=1.279)、ACL胫骨止点宽度减小(OR=1.346)、膝关节内翻角增大(OR=1.769)、内侧胫骨平台后倾角增大(OR=1.957)是陈旧性ACL损伤患者伴发内侧半月板撕裂的危险因素(P<0.05)。结论内侧半月板撕裂与胫骨平台后倾角间存在影响机制,内侧胫骨平台后倾角增大是陈旧性ACL损伤患者伴发内侧半月板撕裂的危险因素。

Objective To analyze the influencing factors of old anterior cruciate ligament(ACL)injury with medial meniscus tear.Methods The clinical data of 200 patients with old ACL injury in Changde First Hospital of Traditional Chinese Medicine from September 2018 to October 2021 were analyzed retrospectively.The patients were divided into study group(with medial meniscus tear)and control group(with normal medial meniscus),with 100 cases in each group.All patients were scanned by magnetic resonance imaging to measure the anatomical parameters of the knee joint(knee varus angle,ACL tibial stop width,medial tibial plateau retroversion angle,tibial coronal inclination angle,medial tibial plateau depth).The anatomical parameters of knee joint were compared between the two groups,and the influencing factors of medial meniscus tear were analyzed by logistic regression model.Results The knee varus angle,medial tibial plateau retroversion angle and tibial coronal inclination angle of the study group were greater than those of the control group,and the ACL tibial insertion width and medial tibial plateau depth were less than those of the control group,the differences were statistically significant(P<0.05).Multivariate logistic analysis showed that the decrease of medial tibial plateau depth(OR=1.152),the increase of tibial coronal inclination angle(OR=1.279),the decrease of ACL tibial stop width(OR=1.346),the increase of knee varus angle(OR=1.769)and the increase of medial tibial plateau caster angle(OR=1.957)were the risk factors of medial meniscus tear in patients with old ACL injury(P<0.05).Conclusion There is an influence mechanism between medial meniscus tear and tibial plateau caster.The increase of medial tibial caster is a risk factor for medial meniscus tear in patients with old ACL injury.