No differences in knee anthropometric-related risk factors between unilateral and bilateral ACL reconstruction: A matched MRI-based cohort study

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-08-05 DOI:10.1002/jeo2.70394

Riccardo D'Ambrosi, Fabrizio Di Maria, Prof. Luca Maria Sconfienza, Stefano Fusco, Maria Vittoria Bausano, Mattia Sica, Francesco Silletta, Elisabeth Abermann, Prof. Christian Fink

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Abstract

Purpose

The primary aims of this retrospective study were to (1) compare medial posterior tibial slope (mPTS), lateral posterior tibial slope (lPTS), notch index and lateral femoral condyle ratio (LFCR) between patients who have undergone unilateral versus bilateral anterior cruciate ligament reconstruction (ACLR), measured on magnetic resonance imaging (MRI) using a matched cohort analysis; (2) evaluate whether subgroup differences exist based on age, gender and side; (3) assess risks factors for ACL injury using logistic models.

Methods

This retrospective study included patients who underwent primary ACLR between 2015 and 2019. Measurements of the unilaterally operated knee (n = 45) were matched using propensity score-matched in a ratio of 1:1 with the corresponding knee in the bilateral group (n = 45) based on age, sex, side, using the greedy nearest neighbour method. Exclusion criteria included inadequate MRI quality (<1.5 Tesla), concomitant ligament injuries or fractures, and <6-year follow-up for unilateral ACLR patients. Five blinded reviewers measured mPTS, lPTS, femoral notch index and LFCR on MRI scans.

Results

No significant differences were observed between the bilateral and unilateral groups for mPTS, lPTS, femoral notch index or LFCR. The mean values for the bilateral group were: mPTS, 3.84° ± 2.54°; lPTS, 6.03° ± 3.63°; notch index, 0.27 ± 0.02; and LFCR, 0.73 ± 0.07. Corresponding values for the unilateral group were: mPTS, 3.92° ± 2.94°; lPTS, 6.37° ± 3.13°; notch index, 0.27 ± 0.03; and LFCR, 0.71 ± 0.06 (all p > 0.05). Subgroup analysis revealed a statistically significant difference only for the femoral notch index in patients older than 25 years: bilateral ACLR (0.29 ± 0.03) versus unilateral ACLR (0.27 ± 0.03; p = 0.027).

Conclusions

Patients who underwent bilateral ACLR showed no significant differences in mPTS, lPTS, femoral notch index or LFCR, compared with those who underwent unilateral ACLR, irrespective of age, gender and side.

Level of Evidence

Level III, cross-sectional study.

Abstract Image

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单侧和双侧前交叉韧带重建的膝关节人体测量相关危险因素无差异：一项匹配的基于mri的队列研究

本回顾性研究的主要目的是：(1)比较单侧和双侧前交叉韧带重建（ACLR）患者的内侧胫骨后斜度（mPTS）、外侧胫骨后斜度（lPTS）、缺口指数和外侧股骨髁比值（LFCR），采用匹配队列分析的磁共振成像（MRI）测量；(2)评估年龄、性别、侧面是否存在亚组差异；(3)运用logistic模型评估前交叉韧带损伤的危险因素。方法回顾性研究纳入2015年至2019年期间接受原发性ACLR的患者。单侧手术膝关节（n = 45）的测量采用倾向性评分匹配，根据年龄、性别、侧位与双侧组（n = 45）的相应膝关节以1:1的比例匹配，采用贪婪近邻法。排除标准包括MRI质量不合格（1.5 Tesla），伴有韧带损伤或骨折，单侧ACLR患者随访6年。5名盲法评价者在MRI扫描上测量mPTS、lPTS、股沟指数和LFCR。结果双侧组与单侧组mPTS、lPTS、股骨切迹指数、LFCR均无显著差异。双侧组的平均值为：mPTS， 3.84°±2.54°；lPTS为6.03°±3.63°；缺口指数，0.27±0.02；LFCR为0.73±0.07。单侧组相应值为：mPTS， 3.92°±2.94°；lPTS为6.37°±3.13°；缺口指数，0.27±0.03；LFCR为0.71±0.06 （p > 0.05）。亚组分析显示，只有25岁以上患者的股骨切迹指数有统计学差异：双侧ACLR（0.29±0.03）与单侧ACLR(0.27±0.03)；p = 0.027)。结论与单侧ACLR患者相比，双侧ACLR患者的mPTS、lPTS、股骨切迹指数或LFCR无显著差异，无论年龄、性别和侧边。证据水平III级，横断面研究。

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