Hefti中高等级运动项目优秀青少年运动员前交叉韧带初次损伤与膝关节解剖结构的相关性分析

Relationship between the Anatomic Risk Factors and the Primary Anterior Cruciate Ligament Injury of Elite Adolescent Athletes in Hefti Medium and High-level Sports

目的:针对Hefti中高等级运动项目优秀青少年运动员,进行前交叉韧带(ACL)初次损伤与膝关节解剖结构的相关性分析研究。方法:回顾性研究。连续选取2016年至2021年收治的ACL首次损伤的Hefti中高等级运动项目青少年运动员21例(研究组),男8例、女13例,年龄16.47±1.40岁(14~18岁),按年龄和性别1:1匹配健康青少年运动员21例(对照组)。利用磁共振测量胫骨平台后倾角(PTS)、髁间窝宽度、股骨髁形态、髁间棘高度、半月板-胫骨平台角(MBA)等指标,比较两组人群的膝关节形态差异,并分析前交叉韧带初次损伤的膝关节解剖风险因素。结果:ACL损伤的青少年运动员的外侧软组织PTS显著大于对照组(2.64°±5.59°vs-1.1°±2.64°,P<0.05),髁间窝宽度(1.61±0.19 cm vs 1.79±0.23 cm)、髁间窝宽度指数(NWI)(0.23±0.02 vs 0.25±0.02)和内侧MBA(24.9°±3.87°vs 28.1°±4.02°)小于对照组(P<0.05)。外侧软组织PTS、髁间窝宽度和内侧MBA为ACL损伤的独立风险因素。结论:外侧软组织PTS越大、髁间窝越窄、内侧MBA越小,青少年运动员ACL损伤风险越高。

Objective To analyze the relationship between the anatomic risk factors and the primary anterior cruciate ligament(ACL) injury of elite adolescent athletes in Hefti medium and high-level sports.Methods It was a retrospective study.A total of 21 adolescent athlete patients of Hefti middleand high-level sports and with first ACL injury between 2016 and 2021 were selected into an experimental group,including 8 males and 13 females,aged 16.47 ± 1.40 years(14~18 years old).Another21 healthy athlete counterparts were chosen into a control group.Magnetic resonance imaging was conducted to measure the posterior tibial slope(PTS),femoral intercondylar notch width,the morphological characteristics of condyles of femur,height of the tibial spines and meniscus-bone angle(MBA).The differences in the morphology of knees were compared between the 2 groups,and the anatomic risk factors for the primary ACL injury were analyzed.Results The lateral meniscus PTS of the experimental group was significantly larger than the control group(2.64° ± 5.59° vs-1.1° ± 2.64°,P<0.05),while the notch width,notch width index and and the medial MBA[(1.61 ± 0.19 cm vs 1.79 ± 0.23cm),(0.23 ± 0.02 vs 0.25 ± 0.02) and(24.9 ± 3.87° vs 28.1 ± 4.02°)] of the former group were significantly smaller compared with the control group(P<0.05).The binary logistic regression analysis showed that the lateral meniscus PTS,the notch width and the medial MBA were risk factors of ACL injury.Conclusion Adolescent athletes with the greater lateral meniscus PTS,the narrower notch width and the smaller medial MBA,are of higher risks of ACL injury.