| 基于EOS双平面成像分析Blumensaat线的空间倾斜度与前交叉韧带损伤的相关性 |
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Received:December 26, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李剑 |
LI Jian |
南京中医药大学中西医结合鼓楼临床医学院 运动医学与成人重建外科, 江苏 南京 210008 |
Department of Sports Medicine and Adult Reconstruction, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, Jiangsu, China |
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| 王渭君 |
WANG Wei-jun |
南京大学医学院附属鼓楼医院 运动医学与成人重建外科, 江苏 南京 210008 |
Department of Sports Medicine and Adult Reconstruction, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 孙明辉 |
SUN Ming-hui |
南京大学医学院附属鼓楼医院 运动医学与成人重建外科, 江苏 南京 210008 |
Department of Sports Medicine and Adult Reconstruction, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 蒋青 |
JIANG Qing |
南京大学医学院附属鼓楼医院 运动医学与成人重建外科, 江苏 南京 210008 |
Department of Sports Medicine and Adult Reconstruction, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
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| 翁文杰 |
WENG Wen-jie |
南京中医药大学中西医结合鼓楼临床医学院 运动医学与成人重建外科, 江苏 南京 210008
南京大学医学院附属鼓楼医院 运动医学与成人重建外科, 江苏 南京 210008 |
Department of Sports Medicine and Adult Reconstruction, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, Jiangsu, China
Department of Sports Medicine and Adult Reconstruction, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China |
drwilliamwang@163.com |
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| 期刊信息：《中国骨伤》2023年36卷，第4期，第329-335页 |
| DOI：10.12200/j.issn.1003-0034.2023.04.007 |
| 基金项目:国家自然科学基金(面上项目)(编号:52071175)；南京市卫生科技发展资金项目(编号:YKK21106) |
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目的： 采用EOS双平面成像系统测量非接触性前交叉韧带(anterior cruciate ligament,ACL)损伤患者Blumensaat线与股骨机械轴间的夹角(angle composed by femoral mechanical axis and Blumensaat line,FMBL角),与侧位X线片上Blumensaat线与股骨远端轴线的夹角(α角)进行比较,评估其与ACL损伤的相关性,预测非接触性ACL损伤易发人群的准确性。
方法： 回顾性分析2018年2月至2020年10月收治的88例(176膝)单侧非接触性ACL损伤患者的双下肢骨骼全长EOS影像资料,男53例,女35例;年龄18~45(30.3±6.2)岁;左侧48例,右侧40例。根据ACL损伤组患者ACL损伤的肢体侧别将测量角度参数分为ACL患侧组和ACL健侧组。并在EOS数据库中选取51例(51膝)非ACL损伤者的完全健康侧肢体作为正常对照组,男28例,女23例;年龄20~44(31.6±5.5)岁;左膝26例,右膝25例。将3组下肢骨骼全长EOS影像3D建模,并测量FMBL角与α角。采用单因素二分类Logistic回归分析角度对ACL状态(正常或撕裂)的影响,并根据受试者工作特征(receiver operating characteristic,ROC)曲线得出最佳临界值。
结果： ACL损伤组与正常对照组年龄、性别和侧别比较,差异无统计学意义(P>0.005)。ACL患侧组FMBL角(32.8±2.3)°与ACL健侧组(32.5±2.3)°比较,差异无统计学意义(P>0.005),但均明显低于正常对照组(37.0±2.0)°(P<0.001)。ACL患侧组、ACL健侧组、正常对照组间α角比较,差异无统计学意义(P>0.005)。单因素二分类Logistic回归分析结果显示,FMBL角是非接触性ACL损伤的危险因素[OR=0.433,95%CI(0.330,0.569),P<0.001]。FMBL角的ROC曲线下面积为0.909[95%CI(0.861,0.958),P<0.001],最佳诊断界点值为33.7°,敏感度70.5%,特异度98.0%。
结论： Blumensaat线与股骨机械轴形成的FMBL角是非接触性ACL损伤的危险因素之一,具有良好的预测准确性,当角度≤ 33.7°时发生非接触性ACL损伤的风险增加。 |
| [关键词]:前交叉韧带 膝关节 Blumensaat线 α角 危险因素 EOS双平面成像 |
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| Correlation between spatial inclination of Blumensaat line and anterior cruciate ligament injury based on EOS biplanar 3D imaging system |
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Abstract:
Objective To explore correlation between femoral mechanical axis and Blumensaat line (FMBL) angle of knee joint (angle between Blumensaat line and femoral mechanical axis),α angle (angle between Blumensaat line and axis of distal femur in sagittal plane) on EOS biplane imaging and non-contact anterior cruciate ligament(ACL) injury,and evaluate angle for its accuracy in predicting the populations prone to non-contact ACL injury.
Methods From February 2018 to October 2020,EOS imaging and clinical data from 88 patients (176 knees) with unilateral non-contact ACL injury were retrospectively analyzed,including 53 males and 35 females,aged from 18 to 45 years old with an average of (30.3±6.2) years old,48 patients on the left side and 40 patients on the right side. The patients were divided into ACL-affected group and ACL-health group according to side of ACL injuries,and 51 patients (51 knees) with non-ACL identified from EOS database were included in normal control group,including 28 males and 23 females,aged from 20 to 44 years old with an average of (31.6±5.5) years old,26 patients on the left side and 25 patients on the right side. Full-length EOS imaging of skeleton extremitatis inferioris among three groups were reconstructed to 3D images of skeletal system with EOS software,and then FMBL angle and α angle were measured on the images. Univariate binary Logistic regression analysis was performed to determine the influence of the univariate(FMBL angle or α angle) on ACL status(normal or torn). And the angle cutoff value for univariate was selected based on receiver operating characteristics curve (ROC) to got the best accuracy.
Results There was no statistically significant difference in age,gender and side distribution between ACL-injured group and normal control group(P>0.005). Statistical analyses (one-way ANOVA) indicated no significant difference in FMBL angle between ACL-injured knee group (32.8±2.3)° and ACL-injured contralateral knee group(32.5±2.3)°(P>0.005),but the values between two groups were significantly lower than that in normal control group (37.0±2.0)°(P<0.001). There was no statistically significant difference in α angle among three groups (P>0.005). Univariate binary Logistic regression analysis demonstrated that FMBL angle was risk factor for non-contact ACL injury[OR=0.433,95%CI(0.330,0.569),P<0.001]. The area under ROC curve for FMBL angle was 0.909[95%CI(0.861,0.958),P<0.001],and the sensitivity and specificity were 70.5% and 98.0% respectively,cut-off value was 33.7°.
Conclusion FMBL angle formed by Blumensaat line and femoral mechanical axis is one of the risk factors for non-contact ACL injury and has good predictive accuracy. The general population with FMBL angle below 33.7° may be increased risk for ACL injury. |
| KEYWORDS:Anterior cruciate ligament Knee joint Blumensaat line α angle Risk factors EOS biplane imaging |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李剑,王渭君,孙明辉,蒋青,翁文杰.基于EOS双平面成像分析Blumensaat线的空间倾斜度与前交叉韧带损伤的相关性[J].中国骨伤,2023,36(4):329~335 |
| 英文格式: | LI Jian,WANG Wei-jun,SUN Ming-hui,JIANG Qing,WENG Wen-jie.Correlation between spatial inclination of Blumensaat line and anterior cruciate ligament injury based on EOS biplanar 3D imaging system[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(4):329~335 |
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