胫骨平台后倾角在前交叉韧带中的应用研究

Study on application of posterior tibial slope angle in anterior cruciate ligament

胫骨平台后倾角(posterior tibial slope angle,PTSA)作为前交叉韧带(anterior cruciate ligament,ACL)损伤的危险因素,引起学者的广泛关注,但其作用机制及诊断治疗在运动医学领域仍旧缺乏系统研究。PTSA的测量目前存在多种方式,本文通过复习文献认为应通过下肢全长X线片进行测量,并结合多种影像资料进行综合评估可以减少误差。较大的PTSA会增加ACL损伤的风险,因此,对于>12°的患者在ACL重建术中应尽可能保留半月板及必要时联合胫骨截骨术矫正治疗,可有效预防韧带再损伤的风险。步态分析对于术前致病模式及术后的康复功能有着重要的参考价值,将对以PTSA为依据的个体化康复策略的制定有着指导意义,以期达到最佳的治疗效果。

Posterior tibial slope angle(PTSA)is a risk factor for anterior cruciate ligament(ACL)injury and has attracted a lot of attention,but its mechanism of action and diagnosis are still not systematically studied in the field of sports medicine.In this paper,we believe that PTSA should be measured by fulllength lower extremity films and combined with multiple imaging data for comprehensive assessment to reduce errors.A large PTSA may increases risk of anterior cruciate ligament injury,so patients with more than 12 degrees of PTSA should be treated by preserving meniscus as much as possible during ACL reconstruction and combining with tibial osteotomy if necessary,which could effectively prevent risk of ligament reinjury.At the same time,gait analysis has an important reference value for preoperative pathogenic pattern and postoperative rehabilitation function,so the author believes that it will have a guiding significance for the development of individualized rehabilitation strategy based on PTSA,in order to achieve the best treatment effect.