严重的骨挫伤是前交叉韧带重建后前外侧韧带撕裂愈合不良的危险因素

IF 2 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-07-30 DOI:10.1016/j.knee.2025.07.009

Nam-Hong Choi , Bong-Seok Yang , Jin-Su Kim , Brian N. Victoroff

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引用次数: 0

摘要

先前的研究表明，前交叉韧带（ACL）重建后，前外侧韧带（ALL）愈合不良组的残余枢轴移位发生率明显高于ALL愈合组。然而，未愈合ALL的危险因素在文献中仍然未知。方法纳入标准为2008年1月至2021年3月受伤后6周内进行腘绳肌腱前交叉韧带重建的患者。纳入的患者合并ALL损伤，术前磁共振成像（MRI）证实。术前ALL损伤按Muramatsu分级，术后ALL愈合按改良的Lee分级（良好、部分和不可见）分级。根据术前和术后MRI的比较，将患者分为改善组和未改善组。骨挫伤的严重程度按Song分类分为无、轻微、中度和严重。结果共纳入128例患者。术前，86例（67.2%）患者有部分ALL撕裂，42例（32.8%）患者有完全撕裂。术后“良好”17例（13.3%），“部分”91例（71.1%），“非目视”20例（15.6%）。改善组38例（29.7%），未改善组90例（70.3%）。骨挫伤的严重程度是ALL“未改善”的危险因素（P = 0.015）。骨挫伤严重程度每增加1级，ALL“未改善”风险增加1.78倍。结论严重骨挫伤与前交叉韧带重建后ALL愈合不良相关。

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Severe bone contusion is a risk factor for poor healing of the anterolateral ligament tear following anterior cruciate ligament reconstructions

Background

A previous study demonstrated that incidence of residual pivot shift following anterior cruciate ligament (ACL) reconstructions was significantly higher in the poorly healed anterolateral ligament (ALL) group than the healed ALL group. However, the risk factor for unhealed ALL remains unknown in literature.

Methods

Inclusion criteria were patients who underwent hamstring ACL reconstructions within 6 weeks after injury from January 2008 to March 2021. Included patients had concomitant ALL injuries that were confirmed by preoperative magnetic resonance imaging (MRI). Preoperative ALL injury was graded by the Muramatsu classification, and postoperative ALL healing was graded by a modification of the Lee classification (good, partial, and non-visualized). The patients were allocated to an improved group and an unimproved group on the basis of a comparison of pre- and postoperative MRI. Severity of bone contusion was graded as none, minimal, moderate, and severe by the Song classification.

Results

128 patients were included. Preoperatively, 86 (67.2 %) patients had partial ALL tears and 42 (32.8 %) patients had complete tears. Postoperatively, 17 (13.3 %) patients showed “good”, 91(71.1 %) showed “partial”, and 20 (15.6 %) showed “non-visualized” healing. Thirty-eight (29.7 %) and 90 (70.3 %) patients were allocated to the improved group and unimproved group, respectively. Severity of the bone contusion was a risk factor for “unimproved” ALL (P = 0.015). As the severity of bone contusion increased 1 grade, risk of “unimproved” ALL increased by 1.78 times.

Conclusion

Severe bony contusion was associated with poor healing of the ALL following ACL reconstructions.

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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.