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1.
The effect of a geographic lateral bone bruise on knee inflammation after acute anterior cruciate ligament rupture 总被引:4,自引:0,他引:4
Johnson DL Bealle DP Brand JC Nyland J Caborn DN 《The American journal of sports medicine》2000,28(2):152-155
We prospectively evaluated 40 patients who had knee inflammation after isolated anterior cruciate ligament rupture with or without an associated "geographic" bone bruise/subchondral fracture of the lateral femoral condyle. All patients with acute ruptures documented by magnetic resonance imaging within 1 week of injury were evaluated for a geographic bone bruise/subchondral fracture of the lateral femoral condyle. Two groups of 20 patients each (bone bruise versus no bone bruise) were then enrolled. Variables measured at 1, 2, 3, and 4 weeks after injury included pain, range of motion, effusion, and number of days with an antalgic gait. Patients with a bone bruise had increased size and duration of effusion, increased number of days required to nonantalgic gait without external aids, increased days to achieve normal range of motion, and increased pain scores at measured time intervals. This study confirms results of previous clinical and histologic studies showing an associated articular cartilage lesion, otherwise known as bone bruise/subchondral fracture, is clinically significant. There appears to be an association between a geographic bone bruise and increased disability in patients with acute anterior cruciate ligament ruptures. Patients with a geographic bone bruise may require longer to reach normal homeostasis (range of motion, pain, neuromuscular control) before undergoing anterior cruciate ligament reconstruction. 相似文献
2.
Anterior cruciate reconstruction combined with autologous osteochondral transplantation 总被引:1,自引:0,他引:1
The purpose of this prospective study was to evaluate the results of simultaneous anterior cruciate ligament (ACL) reconstruction and osteochondral autograft transplantation performed in patients suffering an anterior instability associated with symptomatic full-thickness cartilage defects. Our clinical report includes the first 21 patients (six women, 15 men) who have been followed up for 32 months or longer. The average patient age was 29 years (range 22–44 years), and mean time from injury to the combined reconstructive surgery was 10 months (range 4–27 months). The cartilage defects had a mean area of 3.5 cm2 (range 2.0–5.0 cm2). All patients were evaluated according to the IKDC, Lysholm and Tegner scoring scales by an independent observer. A visual analogue scale (VAS) reflecting patient pain was evaluated. Assessment using the IKDC knee scoring scale revealed 81% of the patients with a normal or nearly normal knee joint. There was a significant improvement in subjective discomfort, and the KT-1000 arthrometric evaluation showed a reduction of the ventral tibial translation (5.9 to 1.9 mm). All but two patients had returned to full activities without restriction and were asymptomatic. The results of this study suggest that symptomatic full-thickness articular cartilage defects associated with ACL instability can be effectively treated by performing ACL reconstruction and osteochondral autologous grafts in one procedure. However, only the years which follow will show the long-term outcome of the patients. 相似文献
3.
Hao Wu Colin Webber Carmen Otero Fuentes Robert Bensen Karen Beattie Jonathan D Adachi Xiaoming Xie Farhang Jabbari David R Levy 《Journal l'Association canadienne des radiologistes》2007,58(3):167-175
OBJECTIVES: 1) To assess, with a peripheral magnetic resonance imaging system (pMRI), the prevalence of bony and soft tissue abnormalities in the knee joints of normal subjects, osteoarthritis (OA) patients, and individuals who have suffered an anterior cruciate ligament (ACL) rupture; and 2) to compare the prevalence among groups. METHODS: Magnetic resonance (MR) images of 28 healthy, 32 OA, and 26 ACL damaged knees were acquired with a 1.0-T pMRI system. Two radiologists graded the presence and severity of 9 MR image features: cartilage degeneration, osteophytes, subchondral cyst, bone marrow edema, meniscal abnormality, ligament integrity, loose bodies, popliteal cysts, and joint effusion. RESULTS: Ten of 28 healthy (35.7%), 24 of 26 ACL (92.3%), and all OA knees (100%) showed prevalent cartilage defects; 5 healthy (17.9%), 20 ACL (76.9%), and all OA knees (100%) had osteophytes; and 9 normal (32.1%), 21 ACL (80.8%), and 29 OA knees (90.6%) had meniscal abnormalities. One-half of the knees in the OA group (16 of 32, 50%) had subchondral cysts, and almost one-half had bone marrow edema (15 of 32, 46.9%). These features were not common in the ACL group (7.7%, and 11.5%, respectively) and were not observed in healthy knees. The OA group had the most severe cartilage defects, osteophytes, bone marrow edema, subchondral cysts, and meniscal abnormalities; the ACL group showed more severe cartilage defects, osteophytes, and meniscal abnormalities than did normal subjects. CONCLUSION: The results suggest that knees that have sustained ACL damage have OA-like reatures; most subjects (19 of 26, 73.1%) could be identified as in the early stage of OA. The prominent abnormalities present in ACL-damaged knees are cartilage defects, osteophytes, and meniscal abnormalities. 相似文献
4.
Szkopek K Warming T Neergaard K Jørgensen HL Christensen HE Krogsgaard M 《Scandinavian journal of medicine & science in sports》2012,22(5):635-642
It is unknown whether the bone bruise that occurs in connection with acute anterior cruciate ligament (ACL) rupture is causing pain and dysfunction. We followed prospectively 17 patients [10 men, seven women, mean age 28 years (range 23-34)] with acute ACL rupture for 2 months. A magnetic resonance imaging (MRI) scan was performed shortly after the injury, and at 2 weeks, 1 month and 2 months. The patients reported the level of pain every day and filled in a Knee injury and Osteoarthritis Outcome Score sheet in connection with MRI. For every MRI of the knee, volume of bone bruise was calculated, and intensity was visually graded. Our study showed a reduction of the pain to 50% approximately 2 weeks after the injury, at which time the bone bruise was at maximum. There was a significant relationship between pain and the volume and intensity of the bone bruise in the medial tibia condyle, as well as pain and the bone bruise volume of the lateral femoral condyle. Patients with bone bruise of the medial tibia and patients with meniscal lesions had more pain. It is suggested that pain and decreased function after acute ACL injury most likely is related to soft tissue and cartilage injury and not to bone bruise. 相似文献
5.
Hovis KK Alizai H Tham SC Souza RB Nevitt MC McCulloch CE Link TM 《Skeletal radiology》2012,41(11):1435-1443
Objectives
The aim of this work was to study anterior cruciate ligament (ACL) degeneration in relation to MRI-based morphological knee abnormalities and cartilage T2 relaxation times in subjects with symptomatic osteoarthritis.Methods
Two radiologists screened the right knee MRI of 304 randomly selected participants in the Osteoarthritis Initiative cohort with symptomatic OA, for ACL abnormalities. Of the 52 knees with abnormalities, 28 had mucoid degeneration, 12 had partially torn ACLs, and 12 had completely torn ACLs. Fifty-three randomly selected subjects with normal ACLs served as controls. Morphological knee abnormalities were graded using the WORMS score. Cartilage was segmented and compartment-specific T2 values were calculated.Results
Compared to normal ACL knees, those with ACL abnormalities had a greater prevalence of, and more severe, cartilage, meniscal, bone marrow, subchondral cyst, and medial collateral ligament lesions (all p?0.05). T2 measurements did not significantly differ by ACL status.Conclusions
ACL abnormalities were associated with more severe degenerative changes, likely because of greater joint instability. T2 measurements may not be well suited to assess advanced cartilage degeneration. 相似文献6.
Kazuki Kato Tamotsu Kamishima Eiji Kondo Tomohiro Onodera Shota Ichikawa 《Radiological physics and technology》2017,10(4):431-438
In previous studies, numerous approaches were proposed that assess knee cartilage volume quantitatively using 3D magnetic resonance (MR) imaging. However, the clinical use of these approaches is limited because 3D MR is prone to metal artifacts in postoperative cases. Our purpose in this study was to validate a method for knee cartilage volume quantification using conventional MR imaging in patients who underwent anterior cruciate ligament (ACL) reconstruction surgery. The study included 16 patients who underwent MR imaging before and 1 year after ACL reconstruction surgery. Knee cartilage volumes were measured by our computer-based method with the use of T1-weighted sagittal images. We classified the cartilage into eight regions and made comparisons between preoperative and postoperative cartilage volumes in each region. There was a significant difference between preoperative and postoperative cartilage volumes with regard to medial posterior weight-bearing, medial posterior, lateral posterior weight-bearing, and lateral posterior portions (p = 0.006, 0.023, 0.017 and 0.002, respectively). These results were consistent with the previous studies showing that knee cartilage loss occurs frequently in these portions due to an anterior subluxation of the tibia accompanied by ACL tear. With our method, knee cartilage volumes could be measured quantitatively with conventional MR imaging in patients who underwent ACL reconstruction surgery. 相似文献
7.
Anterior cruciate ligament reconstruction with the patellar tendon-augmentation or not? 总被引:1,自引:0,他引:1
P. Thuresson R. Sandberg O. Johansson B. Balkfors N. Westlin 《Scandinavian journal of medicine & science in sports》1996,6(4):247-254
The aim of this bi-centre study was to assess the possible effects of the addition of the Kennedy ligament augmentation device (LAD) in the reconstruction of the anterior cruciate ligament (ACL). The method of reconstruction used was a modification of the Brückner and Broström procedures, using the medial third of the patellar tendon tunnelled through the proximal tibia into the lateral femoral condyle and fastened with pull-out sutures. Eighty-two patients with chronic ACL insufficiency and severe symptoms of instability in spite of physiotherapy were randomly selected for reconstruction with or without a LAD. The LAD-augmented knees had the synthetic augmentation stitched to and embedded into the autogenous tissue and the composite graft was pulled through a femoral tunnel and stapled proximally. The patients were followed up regularly and the 2-year results are presented here. The outcome in both groups was good. The augmented-knee group had a larger extension deficit 1 month post-operatively compared to the non-augmented knee group but a smaller extension deficit at the 2-year follow-up. There was no difference in the median of the Lysholm knee function score but there were more patients in the non-augmented group with a lower Lysholm knee function score at the 2-year follow-up. 相似文献
8.
MD Jon K. Sekiya MD Hussein A. Elkousy MD Christopher D. Harner 《Operative Techniques in Sports Medicine》2002,10(3)
The meniscal cartilage plays a vital role in maintaining normal knee function. This important structure providesshock absorption, stabilization, lubrication, proprioception, and load sharing to the knee joint. Although it has been shown that an anterior cruciate ligament (ACL) reconstruction can provide symptomatic pain relief in the arthritic knee, the results following ACL reconstruction in a medial meniscus-deficient knee are usually worse than when the medial meniscus is intact. Given these findings, meniscal allograft transplantation with concomitant ACL reconstruction have been performed to provide patients with a more stable and functional knee as well as to forestall the degenerative process. We report our indications, preoperative considerations, surgical technique, postoperative rehabilitation protocol, and results with meniscal allograft transplantation combined with ACL reconstruction. We believe that meniscal transplantation combined with ACL reconstruction, in appropriately selected patients with meniscus- and ACL-deficient knees, offers significant advantages that cannot be accomplished with either procedure alone. Although technically challenging, careful attention to the details outlined will help to avoid pitfalls and will maximize the opportunity for a successful outcome. Our results suggest that this procedure can predictably improve subjective measures of function and symptoms while objectively restoring stability and affording protection to the articular surfaces of the transplanted knee compartment. 相似文献
9.
Rainer Siebold Ioannis S. Benetos Nico Sartory Zhenming He Nawid Hariri Hans H. Pässler 《Knee surgery, sports traumatology, arthroscopy》2010,18(1):64-67
Double bundle (DB) anterior cruciate ligament (ACL) reconstruction is technically demanding. In order to create four anatomical
anteromedial (AM) and posterolateral (PL) bone tunnels many surgeons adopt new ways of tibial and femoral bone tunnel drilling.
From surgical experience, these technical changes might increase the risk for intraoperative pitfalls. An intraoperative articular
cartilage damage to the medial femoral condyle or the medial tibial plateau could be disastrous for the patient. It may be
caused by an insufficient anteromedial portal technique for femoral AM and PL bone tunnel drilling or flat tibial AM or PL
bone tunnel reaming. Potential pitfalls may be avoided by small modifications to the surgical technique. In this present technical
note, a sequence of surgical steps are described, which may help to avoid articular cartilage damage to the medial femoral
condyle and medial tibial plateau in anatomical four tunnel DB ACL reconstruction. 相似文献
10.
Logan M Williams A Lavelle J Gedroyc W Freeman M 《The American journal of sports medicine》2004,32(8):1915-1922
BACKGROUND: Alteration of the kinematics of the PCL-deficient knee might be a factor in producing the articular damage. Very little is known about the in vivo weightbearing kinematics of the PCL-deficient knee. HYPOTHESIS: Isolated rupture of the posterior cruciate ligament alters knee kinematics, predisposing the patient to development of early osteoarthritis. STUDY DESIGN: Case series. METHODS: Tibiofemoral motion was assessed using open-access magnetic resonance imaging, weightbearing in a squat, through the arc of flexion from 0 degrees to 90 degrees in 6 patients with isolated rupture of the posterior cruciate ligament in one knee and a normal contralateral knee. Passive sagittal laxity was assessed by performing the posterior and anterior drawer tests while the knees were scanned, again using the same magnetic resonance imaging scanner. The tibiofemoral positions during this stress magnetic resonance imaging examination were measured from midmedial and midlateral sagittal images of the knees. RESULTS: Rupture of the posterior cruciate ligament leads to an increase in passive sagittal laxity in the medial compartment of the knee (P < .006). In the weightbearing scans, posterior cruciate ligament rupture alters the kinematics of the knee with persistent posterior subluxation of the medial tibia so that the femoral condyle rides up the anterior upslope of the medial tibial plateau. This fixed subluxation was observed throughout the extension-flexion arc and was statistically significant at all flexion angles (P < .018 at 0 degrees , P < .013 at 20 degrees , P < .014 at 45 degrees , P < .004 at 90 degrees ). The kinematics of the lateral compartment were not altered by posterior cruciate ligament rupture. The posterior drawer test showed increased laxity in the medial compartment. CONCLUSION: Posterior cruciate ligament rupture alters the kinematics of the medial compartment of the knee, resulting in "fixed" anterior subluxation of the medial femoral condyle (posterior subluxation of the medial tibial plateau). This study helps to explain the observation of increased incidence of osteoarthritis in the medial compartment, and specifically the femoral condyle, in posterior cruciate ligament-deficient knees. 相似文献
11.
T. Hogervorst T. H. Pels Rijcken C. P. van der Hart E. S. M. De Lange W. K. Taconis 《Knee surgery, sports traumatology, arthroscopy》2000,8(3):137-142
Many patients with anterior cruciate ligament (ACL) deficiency have an abnormal bone scan. This finding has not yet been
explained. Suggested explanations include intra-articular (structural) or kinematic (functional) abnormalities. We examined
the relationship between bone scintigraphy and cartilage degeneration or meniscal lesions in the ACL-deficient knee in 95
consecutive patients who had bone scintigraphy 1–3 days prior to arthroscopic ACL reconstruction. Intra-articular abnormalities
of the knee did not explain all scintigraphic patterns of this study. We did not find clinically useful positive predictive
values for scintigraphic patterns considered to indicate cartilage degeneration or a lateral meniscus lesion. A clinically
useful positive predictive value was found only for medial meniscus lesions when time since ACL rupture was more than 18 months,
and for local cartilage degeneration when markedly increased uptake was seen when time since ACL rupture was more than 4 months.
Considering these findings, alternative explanations are discussed, based on specific aspects of abnormal kinematics and adaptive
bone metabolism of the ACL-deficient knee.
Received: 15 October 1999/Accepted: 25 February 2000 相似文献
12.
Jacques Menetrey Florence Unno-Veith Henning Madry Iwan Van Breuseghem 《Knee surgery, sports traumatology, arthroscopy》2010,18(4):463-471
Articular cartilage and the subchondral bone act as a functional unit. Following trauma, osteochondritis dissecans, osteonecrosis
or osteoarthritis, this intimate connection may become disrupted. Osteochondral defects—the type of defects that extend into
the subchondral bone—account for about 5% of all articular cartilage lesions. They are very often caused by trauma, in about
one-third of the cases by osteoarthritis and rarely by osteochondritis dissecans. Osteochondral defects are predominantly
located on the medial femoral condyle and also on the patella. Frequently, they are associated with lesions of the menisci
or the anterior cruciate ligament. Because of the close relationship between the articular cartilage and the subchondral bone,
imaging of cartilage defects or cartilage repair should also focus on the subchondral bone. Magnetic resonance imaging is
currently considered to be the key modality for the evaluation of cartilage and underlying subchondral bone. However, the
choice of imaging technique also depends on the nature of the disease that caused the subchondral bone lesion. For example,
radiography is still the golden standard for imaging features of osteoarthritis. Bone scintigraphy is one of the most valuable
techniques for early diagnosis of spontaneous osteonecrosis about the knee. A CT scan is a useful technique to rule out a
possible depression of the subchondral bone plate, whereas a CT arthrography is highly accurate to evaluate the stability
of the osteochondral fragment in osteochondritis dissecans. Particularly for the problem of subchondral bone lesions, image
evaluation methods need to be refined for adequate and reproducible analysis. This article highlights recent studies on the
epidemiology and imaging of the subchondral bone, with an emphasis on magnetic resonance imaging. 相似文献
13.
Ronny Lorentzon H. Alfredson Christer Hildingsson 《Knee surgery, sports traumatology, arthroscopy》1998,6(4):202-208
Twenty-six consecutive patients (19 men and 7 women) with a mean age of 31.5 years (range 19–52 years) who suffered from
an isolated full-thickness cartilage defect of the patella (area ranged from 0.75 to 20.0 cm2) and disabling knee pain were treated with autologous periosteal transplantation (without any chondrocytes). The duration
of symptoms was 59 months (range 11–144 months). During the first 5 postoperative days all patients were treated with continuous
passive motion (CPM). This was followed by active motion, slowly progressive strength training, and slowly progressive weight-bearing.
After a mean follow-up of 42 months (range 24–76 months), 17 patients (65%) were graded as excellent (were painfree), 8 patients
(31%) as good (had pain with strenous knee-loading activities), and 1 patient as poor (had pain at rest). Twenty-two patients
(85%) had returned to their previous occupation. Twelve patients (46%) had resumed sports or recreational activities at their
former level. Repeated magnetic resonance imaging (MRI) investigations showed progressive, and finally complete, filling of
the articular defects. Biopsies taken in five randomly selected cases showed hyaline-like cartilage. Patients with full-thickness
cartilage defects of the patella and disabling knee pain can be treated with autologous periosteal transplantation (without
any chondrocytes), followed by CPM, and slowly progressive strength training and weight-bearing. We believe this is a good
method to accomplish regeneration of articular cartilage and satisfactory clinical results.
Received: 25 March 1998 Accepted: 14 April 1998 相似文献
14.
P H Marks J A Goldenberg W C Vezina M J Chamberlain A D Vellet P J Fowler 《Journal of nuclear medicine》1992,33(4):516-520
Bone scintigraphy is used to detect radiographically silent fractures. Magnetic resonance imaging (MRI) is currently used to screen knee injuries for cartilage and ligament damage. MRI also delineates bone marrow and fractures. We investigated the bone scintigraphic findings in patients who had subchondral bone injuries demonstrated on MRI. Thirteen patients underwent MRI, three-phase bone scintigraphy with SPECT, and arthroscopic surgery after sustaining acute traumatic hemarthrosis of a knee. They all had clinically unsuspected subchondral bone injuries demonstrated on MRI with normal radiographs and normal overlying articular cartilage at arthroscopy, consistent with occult fractures. All showed focal bone repair on scintigraphy. Two of the 13 patients showed additional bone injuries only on bone scan. Two other patients scintigraphically showed focal bone repair at the medial femoral condyle due to avulsion of the medial collateral ligament. SPECT was easier to interpret than multi-view planar imaging. Bone scintigraphy confirms subchondral fractures demonstrated on MRI but also demonstrates ligament avulsion injuries and additional more subtle bone injuries. 相似文献
15.
Makoto Nishimori Masataka Deie Nobuo Adachi Atsushi Kanaya Atsuo Nakamae Mitsuru Motoyama Mitsuo Ochi 《Knee surgery, sports traumatology, arthroscopy》2008,16(3):270-274
Thirty-nine knees in 39 patients with recent anterior cruciate ligament (ACL) rupture (age 14–55 years; with a mean age of
22.8 years) were selected from our cases of ACL reconstruction from July 2005 to June 2006, to take part in a study on articular
cartilage injury of the posterior lateral tibial plateau associated with acute ACL injury and on the correlation between bone
bruises depicted on MRI and cartilage injury of the posterior lateral tibial plateau detected at arthroscopic ACL reconstruction.
Using preoperative MRI, we evaluated whether there were bone bruises or not in the lateral compartment of the knee and divided
them accordingly into two groups: the bone bruise positive group and the negative group. The differences in the proportions
of the lateral meniscus (LM) tears and the cartilage injuries in the two groups were evaluated using Fisher’s exact probability
test. Thirty-five cases out of 39 arthroscopic ACL reconstructions (89.7%) were regarded as bone bruise positive in the lateral
compartment and four cases (10.3%) were regarded as negative. At arthroscopic ACL reconstruction, 33 cases (84.6%) had tears
in the LM posterior horn, 34 cases (87.2%) had articular cartilage injuries in the lateral femoral condyle and 29 cases (74.3%)
had articular cartilage injuries in the posterior lateral tibial plateau. From 35 bone bruise positive cases, 32 cases (91.4%)
had tears in the LM posterior horn, 33 cases (94.3%) had articular cartilage injuries in the lateral femoral condyle and 28
cases (80%) had articular cartilage injuries in the posterior lateral tibial plateau. Of four bone bruise negative cases,
one case (25%) had a tear in the LM posterior horn, articular cartilage injury of the lateral femoral condyle and of the posterior
lateral tibial plateau. There was a statistically significant correlation between the proportion of bone bruise and cartilage
injury of the lateral femoral condyle (P = 0.004), that of the posterior lateral tibial plateau (P = 0.04) and that of tears in the LM posterior horn (P = 0.008). This current study has demonstrated that we need to pay attention to cartilage damage of the posterior lateral tibial
plateau as well as to posterior horn tears in LM, when acute ACL injury is shown. We also have to ensure that we follow the
long-term progress of cartilage injuries, with the aim of preventing these injuries becoming osteoarthritis after ACL reconstruction. 相似文献
16.
We report a case of a mucoid degeneration of the anterior cruciate ligament (ACL) that produced osseous erosion of the medial aspect of the lateral femoral condyle. The MRI findings and differential diagnosis are discussed. 相似文献
17.
Anatomic placement of the femoral tunnel in anterior cruciate ligament (ACL) reconstruction confers biomechanical advantages over the traditional tunnel position. The anteromedial portal technique for anatomic ACL reconstruction has many well-described technical challenges. This paper describes the TransLateral technique. The technique produces anatomic femoral tunnel placement using direct measurement of the medial wall of the lateral femoral condyle and out to in drilling. All work is carried out through the lateral portal with all viewing via the medial portal. There is no need for an accessory medial portal or hyperflexion of the knee. Level of evidence Expert opinion, Level V. 相似文献
18.
膝关节内侧副韧带、前交叉韧带、后交叉韧带联合损伤的手术治疗 总被引:10,自引:3,他引:7
目的探讨关节镜下膝关节前交叉韧带(ACL)、后交叉韧带(PCL)、内侧副韧带联合损伤(Ⅲ度膝关节外翻伤)的手术治疗方法。方法关节镜下同时联合重建ACL、PCL并修复内侧副韧带和内侧关节囊,8例交叉韧带重建材料来源于自体双侧髌腱中1/3骨-腱-骨结构,8例采用同种异体髌腱重建,交叉韧带重建的同时进行膝关节内侧副韧带和关节囊的修补。术后佩戴可调式卡盘支具3个月,并给予严格的康复训练。结果术后随访6~18个月,所有患者主观感觉以及膝关节稳定程度恢复良好,均进行正常生活与工作,同种异体髌腱移植重建比自体髌腱移植重建前后交叉韧带手术时间短,效果更好,没有发现明显的排异反应和感染传染性疾病的现象。结论1期行关节镜手术治疗膝关节内侧副韧带、前交叉韧带/后交叉韧带联合损伤,使用安全,效果满意;同种异体髌腱是重建物是一个可以选择的来源,效果优于自体髌腱移植重建。 相似文献
19.
Lazar Stijak Richard F. Herzog Pascal Schai 《Knee surgery, sports traumatology, arthroscopy》2008,16(2):112-117
This study examines the effect of the tibial slope on the anterior cruciate ligament lesion (separately on the lateral and
medial tibial condyle). The study consisted of 33 matched pairs of patients divided into two groups: an examined group with
a diagnosed ACL lesion, and a control group with diagnosed patellofemoral pain. The patients were matched on the basis of
four attributes: age, sex, type of lesion (whether it was profession-related), and whether the lesion was left- or right-sided.
Measurements were carried out by radiography and MRI. In the examined group, the lateral tibial plateau was significantly
greater than in the control group (P < 0.001), and the medial tibial plateau had lower tibial slope values than the control group; however, the difference was
not statistically significant (P = 0.066). In both groups, the difference between the slopes on the lateral and medial plateaus was statistically significant
(P < 0.001). In relation to ACL intact patients, population with ACL rupture have greater tibial slope of the lateral condyle.
The greater tibial slope of the lateral tibial plateau may be the factor that leads to the injury of the anterior cruciate
ligament. Compared to the medial plateau, the population with ACL rupture have a greater tibial slope on the lateral plateau,
while the population of the intact ACL have greater tibial slope on the medial plateau. The tibial slope of the medial and
lateral condyle should be compared separately because the values obtained from the two sets of data were different, revealing
apparently opposing effects on the ACL lesion. 相似文献
20.
前交叉韧带斜冠状面薄层解剖断面与MRI表现对照研究 总被引:5,自引:0,他引:5
目的对冰冻膝关节前交叉韧带(ACL)斜冠状面薄层解剖断面与正常人膝关节MRI特点进行对照研究,为ACL损伤分级诊断建立基础。方法1例(1只)膝关节标本行斜冠状面MRI确定角度,冰冻后沿斜冠状面1mm层厚铣切,观察ACL薄层解剖特点。选择50名正常人对其ACL进行MR斜冠状面扫描,观察ACL的MRI特点。结果1只膝关节标本的ACL在斜冠状面薄层断面清晰显示其全程走行,清晰地显示ACL前内束与后外束,前内束从股骨髁附着点后上方区自后向外侧及前内侧走行,止于髁间棘附着区前内侧方,后外侧束从股骨髁附着点前下方区,自后外侧及外下走行,止于髁间棘附着区后外侧方。斜冠状面MRI能够显示50名正常人ACL全程,显示率为100%。MRI能够区分ACL前内束与后外束结构,显示前内束自后外侧向前内走行,止于髁间棘附着区前内侧方,后外束自后外侧向外下走行,止于髁间棘附着区后外侧方。MRI显示ACL走行与薄层断面显示的走行一致。结论斜冠状面是观察ACL的最佳方位,临床对怀疑ACL损伤的患者必要时行MR斜冠状面扫描。 相似文献