通过对 141 名儿童进行前瞻性研究，为使用 GNRB® 的受伤儿童群体确定前十字韧带损伤阈值。

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-10-19 DOI:10.1016/j.knee.2024.09.011

Théo Cojean , Catherine Mulier , Laurence Cheze , Franck Chotel

{"title":"通过对 141 名儿童进行前瞻性研究，为使用 GNRB® 的受伤儿童群体确定前十字韧带损伤阈值。","authors":"Théo Cojean , Catherine Mulier , Laurence Cheze , Franck Chotel","doi":"10.1016/j.knee.2024.09.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Treating an anterior cruciate ligament (ACL) injury in pediatric patients is challenging. The GNRB® is a diagnostic tool for laximetry and can provide valuable information for clinical decision. As few data exist on this subject, the first objective is to provide physiological laxity values of anterior tibial translation in healthy and pathological knees in pediatric population by age and gender groups. A second objective is to establish injury thresholds with the GNRB®.</div></div><div><h3>Methods</h3><div>This prospective study included 141 pediatric patients with a complete ACL tear. They all underwent GNRB® measurements before the surgery. Age and gender groups were created: child/adolescent girls and child/adolescent boys. Thresholds were established using ROC curves and 2-factors ANOVA tests were used for comparisons.</div></div><div><h3>Results</h3><div>A significant age effect was found for laxities measured on healthy knees. Significant age and gender effects were found for laxities measured on pathological knees and for side-to-side differences of laxity (SSD) between healthy and pathological knees. The optimal threshold to detect a complete ACL rupture with GNRB® is 1.5 mm at 134N with a sensitivity of 83.7% and a specificity of 92.7%.</div></div><div><h3>Conclusion</h3><div>GNRB® brought new information about ACL laxities for healthy and pathological knees in pediatric population. Children have a greater anterior tibial translation which decreases gradually with age, and girls have grater laxities than boys. Thresholds for complete ACL tears, presenting good predictive values, were established and can help surgeons in their decisions to improve clinical practice.</div><div><strong>Level of evidence:</strong> Prospective cohort study, level of evidence III.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 268-275"},"PeriodicalIF":1.6000,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Establishment of anterior cruciate ligament injury thresholds for injured pediatric population with GNRB®, a prospective study on 141 children\",\"authors\":\"Théo Cojean , Catherine Mulier , Laurence Cheze , Franck Chotel\",\"doi\":\"10.1016/j.knee.2024.09.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Treating an anterior cruciate ligament (ACL) injury in pediatric patients is challenging. The GNRB® is a diagnostic tool for laximetry and can provide valuable information for clinical decision. As few data exist on this subject, the first objective is to provide physiological laxity values of anterior tibial translation in healthy and pathological knees in pediatric population by age and gender groups. A second objective is to establish injury thresholds with the GNRB®.</div></div><div><h3>Methods</h3><div>This prospective study included 141 pediatric patients with a complete ACL tear. They all underwent GNRB® measurements before the surgery. Age and gender groups were created: child/adolescent girls and child/adolescent boys. Thresholds were established using ROC curves and 2-factors ANOVA tests were used for comparisons.</div></div><div><h3>Results</h3><div>A significant age effect was found for laxities measured on healthy knees. Significant age and gender effects were found for laxities measured on pathological knees and for side-to-side differences of laxity (SSD) between healthy and pathological knees. The optimal threshold to detect a complete ACL rupture with GNRB® is 1.5 mm at 134N with a sensitivity of 83.7% and a specificity of 92.7%.</div></div><div><h3>Conclusion</h3><div>GNRB® brought new information about ACL laxities for healthy and pathological knees in pediatric population. Children have a greater anterior tibial translation which decreases gradually with age, and girls have grater laxities than boys. Thresholds for complete ACL tears, presenting good predictive values, were established and can help surgeons in their decisions to improve clinical practice.</div><div><strong>Level of evidence:</strong> Prospective cohort study, level of evidence III.</div></div>\",\"PeriodicalId\":56110,\"journal\":{\"name\":\"Knee\",\"volume\":\"51 \",\"pages\":\"Pages 268-275\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-10-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0968016024001777\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0968016024001777","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

摘要

背景：治疗儿童患者的前十字韧带损伤具有挑战性。GNRB® 是一种松弛测量诊断工具，可为临床决策提供有价值的信息。由于这方面的数据很少，我们的第一个目标是按年龄组和性别组提供健康和病理膝关节的胫骨前平移生理松弛值。第二个目标是使用 GNRB® 确定损伤阈值：这项前瞻性研究包括 141 名前交叉韧带完全撕裂的儿科患者。他们都在手术前接受了 GNRB® 测量。年龄和性别分组为：儿童/青少年女孩组和儿童/青少年男孩组。使用 ROC 曲线确定阈值，并使用 2 因子方差分析进行比较：结果：在健康膝关节上测量的松弛程度存在明显的年龄效应。在病理膝关节上测量的松弛度以及健康膝关节和病理膝关节之间的侧向松弛度差异（SSD）均有明显的年龄和性别效应。使用 GNRB® 检测前交叉韧带完全断裂的最佳阈值是 134N 处的 1.5 毫米，灵敏度为 83.7%，特异度为 92.7%：结论：GNRB®为健康和病理膝关节的前交叉韧带松弛带来了新的信息。儿童的胫骨前移较大，随着年龄的增长而逐渐减小，女孩的松弛程度大于男孩。前交叉韧带完全撕裂的阈值已经确定，具有良好的预测价值，可以帮助外科医生做出决定，改善临床实践：前瞻性队列研究，证据等级 III。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Establishment of anterior cruciate ligament injury thresholds for injured pediatric population with GNRB®, a prospective study on 141 children

Background

Treating an anterior cruciate ligament (ACL) injury in pediatric patients is challenging. The GNRB® is a diagnostic tool for laximetry and can provide valuable information for clinical decision. As few data exist on this subject, the first objective is to provide physiological laxity values of anterior tibial translation in healthy and pathological knees in pediatric population by age and gender groups. A second objective is to establish injury thresholds with the GNRB®.

Methods

This prospective study included 141 pediatric patients with a complete ACL tear. They all underwent GNRB® measurements before the surgery. Age and gender groups were created: child/adolescent girls and child/adolescent boys. Thresholds were established using ROC curves and 2-factors ANOVA tests were used for comparisons.

Results

A significant age effect was found for laxities measured on healthy knees. Significant age and gender effects were found for laxities measured on pathological knees and for side-to-side differences of laxity (SSD) between healthy and pathological knees. The optimal threshold to detect a complete ACL rupture with GNRB® is 1.5 mm at 134N with a sensitivity of 83.7% and a specificity of 92.7%.

Conclusion

GNRB® brought new information about ACL laxities for healthy and pathological knees in pediatric population. Children have a greater anterior tibial translation which decreases gradually with age, and girls have grater laxities than boys. Thresholds for complete ACL tears, presenting good predictive values, were established and can help surgeons in their decisions to improve clinical practice.

Level of evidence: Prospective cohort study, level of evidence III.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.