Lateral femoral impaction fractures during an ACL tear extend posteriorly on the weight-bearing area of the tibiofemoral joint

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-10-24 DOI:10.1002/ksa.12438

Konrad Malinowski, Marcin Mostowy, Kacper Ruzik, Krzysztof Starszak, Grzegorz Maciąg, Paweł Skowronek, Michael T. Hirschmann, Przemysław A. Pękala, Robert F. LaPrade, Dong Woon Kim

{"title":"Lateral femoral impaction fractures during an ACL tear extend posteriorly on the weight-bearing area of the tibiofemoral joint","authors":"Konrad Malinowski, Marcin Mostowy, Kacper Ruzik, Krzysztof Starszak, Grzegorz Maciąg, Paweł Skowronek, Michael T. Hirschmann, Przemysław A. Pękala, Robert F. LaPrade, Dong Woon Kim","doi":"10.1002/ksa.12438","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Posterior elongation of the physiological terminal sulcus (TS) due to lateral femoral condyle impaction fracture (LFC-IF) after an anterior cruciate ligament (ACL) tear could potentially decrease the weight-bearing area of the tibiofemoral joint, decrease the tension on lateral meniscus and cause flattening of the LFC which would influence rotational knee motion and cause anisometry of the lateral and anterolateral stabilizers. Therefore, the purpose of the study was to assess if the LFC-IF elongates the physiological TS posteriorly.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>One hundred patients magnetic resonance images (MRIs) (75 males, 25 females, mean age 32.2 years, SD = 8.2) were included with a 1:1 ratio between the full-thickness ACL tear group and the control group (patients with knee MRI performed due to other reasons, with no tear of ACL on MRI and negative clinical tests). Two independent raters evaluated the sagittal T1-weighted preselected MRI scans. The principal measurement of interest was the distance from the intersection of the Blumensaat line with subchondral bone to the posterior border of the TS/LFC-IF.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The median distance from the Blumensaat line to the posterior border of the TS/LFC-IF was significantly higher in the ACL tear group: 14.3 mm, interquartile range (IQR) = 11.6–16.4 mm versus control group: 12.8 mm, IQR = 9.0–15.0 mm, <i>p</i> = 0.038. Intrarater and inter-rater reliabilities were >0.90.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>LFC-IF after full-thickness ACL tear significantly elongates the physiological TS in the posterior direction.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 4","pages":"1270-1280"},"PeriodicalIF":3.3000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ksa.12438","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Posterior elongation of the physiological terminal sulcus (TS) due to lateral femoral condyle impaction fracture (LFC-IF) after an anterior cruciate ligament (ACL) tear could potentially decrease the weight-bearing area of the tibiofemoral joint, decrease the tension on lateral meniscus and cause flattening of the LFC which would influence rotational knee motion and cause anisometry of the lateral and anterolateral stabilizers. Therefore, the purpose of the study was to assess if the LFC-IF elongates the physiological TS posteriorly.

Methods

One hundred patients magnetic resonance images (MRIs) (75 males, 25 females, mean age 32.2 years, SD = 8.2) were included with a 1:1 ratio between the full-thickness ACL tear group and the control group (patients with knee MRI performed due to other reasons, with no tear of ACL on MRI and negative clinical tests). Two independent raters evaluated the sagittal T1-weighted preselected MRI scans. The principal measurement of interest was the distance from the intersection of the Blumensaat line with subchondral bone to the posterior border of the TS/LFC-IF.

Results

The median distance from the Blumensaat line to the posterior border of the TS/LFC-IF was significantly higher in the ACL tear group: 14.3 mm, interquartile range (IQR) = 11.6–16.4 mm versus control group: 12.8 mm, IQR = 9.0–15.0 mm, p = 0.038. Intrarater and inter-rater reliabilities were >0.90.

Conclusion

LFC-IF after full-thickness ACL tear significantly elongates the physiological TS in the posterior direction.

Level of Evidence

Level III.

查看原文本刊更多论文

前交叉韧带撕裂时，股骨外侧撞击性骨折会向后延伸至胫股关节的负重区。

目的：前交叉韧带（ACL）撕裂后，股骨外侧髁嵌顿骨折（LFC-IF）导致生理性末端沟（TS）向后拉长，可能会减少胫股关节的负重面积，降低外侧半月板的张力，并导致 LFC 变平，从而影响膝关节的旋转运动，造成外侧和前外侧稳定器的异位。因此，本研究的目的是评估 LFC-IF 是否会向后拉长生理 TS：方法：100 名患者（75 名男性，25 名女性，平均年龄 32.2 岁，SD = 8.2）接受磁共振成像（MRI）检查，全厚前交叉韧带撕裂组和对照组（因其他原因接受膝关节 MRI 检查，MRI 检查未发现前交叉韧带撕裂且临床检查结果为阴性的患者）的比例为 1:1。两名独立评分员对预选的矢状T1加权核磁共振成像扫描结果进行评估。主要测量指标是布卢门萨特线与软骨下骨交点到 TS/LFC-IF 后缘的距离：结果：前交叉韧带撕裂组从布卢门萨特线到 TS/LFC-IF 后缘的中位距离明显高于前交叉韧带撕裂组：14.3毫米，四分位间距（IQR）= 11.6-16.4毫米；对照组为12.8毫米，四分位间距（IQR）= 11.6-16.4毫米：12.8 mm，IQR = 9.0-15.0 mm，P = 0.038。评分者内部和评分者之间的信度均大于 0.90：结论：全厚前交叉韧带撕裂后的 LFC-IF 可显著拉长后方方向的生理 TS：证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).