Sang-Gyun Kim, Soo-Hyun Kim, Won-Suk Choi, Ji-Hoon Bae
{"title":"仰卧位膝屈90°侧位x线片对慢性后交叉韧带损伤的诊断准确性与应力x线片相似。","authors":"Sang-Gyun Kim, Soo-Hyun Kim, Won-Suk Choi, Ji-Hoon Bae","doi":"10.1007/s00167-018-5228-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether supine lateral radiographs (SLRs) could replace stress radiographs for diagnosing chronic posterior cruciate ligament (PCL) injuries and identifying combined PCL injuries (defined as PCL injury with medial collateral ligament or posterolateral ligament complex injury).</p><p><strong>Methods: </strong>In this retrospective study, both SLRs at 30° and 90° of knee flexion (30/90 SLRs) and Telos stress radiographs of patients with chronic PCL injuries (n = 38) and only 30/90 SLRs of healthy controls (n = 84) were taken. Injured-to-normal differences on 30/90 SLRs and stress radiographs were assessed. Correlation analysis was performed to evaluate injured-to-normal differences on 30/90 SLRs and stress radiographs in patients with chronic PCL injury. Subgroup analysis was performed to compare injured-to-normal differences on 30/90 SLRs and stress radiographs between the isolated and combined PCL injury groups. Receiver operating characteristic curves based on 30/90 SLRs were calculated to determine the cut-off value for diagnosing chronic PCL injury and identifying combined PCL injury.</p><p><strong>Results: </strong>Injured-to-normal differences on both 30 SLRs (3.1 ± 3.6 vs 1.6 ± 1.2, P = 0.019) and 90 SLRs (7.5 ± 3.5 vs 1.2 ± 1.0, P < 0.001) were significantly greater in patients with chronic PCL injuries than in healthy controls. Further, 90 SLRs had a highly accurate diagnostic value for chronic PCL injuries (area under the curve 0.958). The cut-off value for diagnosing chronic PCL injuries based on 90 SLRs was 3.0 mm (sensitivity, 94.7%; specificity, 92.9%). Injured-to-normal differences on 30/90 SLRs were significantly correlated with those on stress radiographs. The correlation coefficients were 0.397 (P = 0.014) for 30 SLRs and 0.605 (P < 0.001) for 90 SLRs. The cut-off value for diagnosing combined PCL injuries based on 90 SLRs was 9.6 mm (area under the curve 0.72).</p><p><strong>Conclusions: </strong>The diagnostic accuracy of 90 SLRs for chronic PCL injuries was similar to that of stress radiographs. Therefore, the 90 SLRs are reliable alternative method to assess the posterior knee laxity when the stress radiographs are not available.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":"2433-2439"},"PeriodicalIF":0.0000,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00167-018-5228-4","citationCount":"8","resultStr":"{\"title\":\"Supine lateral radiographs at 90° of knee flexion have a similar diagnostic accuracy for chronic posterior cruciate ligament injuries as stress radiographs.\",\"authors\":\"Sang-Gyun Kim, Soo-Hyun Kim, Won-Suk Choi, Ji-Hoon Bae\",\"doi\":\"10.1007/s00167-018-5228-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to evaluate whether supine lateral radiographs (SLRs) could replace stress radiographs for diagnosing chronic posterior cruciate ligament (PCL) injuries and identifying combined PCL injuries (defined as PCL injury with medial collateral ligament or posterolateral ligament complex injury).</p><p><strong>Methods: </strong>In this retrospective study, both SLRs at 30° and 90° of knee flexion (30/90 SLRs) and Telos stress radiographs of patients with chronic PCL injuries (n = 38) and only 30/90 SLRs of healthy controls (n = 84) were taken. Injured-to-normal differences on 30/90 SLRs and stress radiographs were assessed. Correlation analysis was performed to evaluate injured-to-normal differences on 30/90 SLRs and stress radiographs in patients with chronic PCL injury. Subgroup analysis was performed to compare injured-to-normal differences on 30/90 SLRs and stress radiographs between the isolated and combined PCL injury groups. Receiver operating characteristic curves based on 30/90 SLRs were calculated to determine the cut-off value for diagnosing chronic PCL injury and identifying combined PCL injury.</p><p><strong>Results: </strong>Injured-to-normal differences on both 30 SLRs (3.1 ± 3.6 vs 1.6 ± 1.2, P = 0.019) and 90 SLRs (7.5 ± 3.5 vs 1.2 ± 1.0, P < 0.001) were significantly greater in patients with chronic PCL injuries than in healthy controls. Further, 90 SLRs had a highly accurate diagnostic value for chronic PCL injuries (area under the curve 0.958). The cut-off value for diagnosing chronic PCL injuries based on 90 SLRs was 3.0 mm (sensitivity, 94.7%; specificity, 92.9%). Injured-to-normal differences on 30/90 SLRs were significantly correlated with those on stress radiographs. The correlation coefficients were 0.397 (P = 0.014) for 30 SLRs and 0.605 (P < 0.001) for 90 SLRs. The cut-off value for diagnosing combined PCL injuries based on 90 SLRs was 9.6 mm (area under the curve 0.72).</p><p><strong>Conclusions: </strong>The diagnostic accuracy of 90 SLRs for chronic PCL injuries was similar to that of stress radiographs. Therefore, the 90 SLRs are reliable alternative method to assess the posterior knee laxity when the stress radiographs are not available.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>\",\"PeriodicalId\":520702,\"journal\":{\"name\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"volume\":\" \",\"pages\":\"2433-2439\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1007/s00167-018-5228-4\",\"citationCount\":\"8\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00167-018-5228-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2018/10/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00167-018-5228-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/10/25 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 8
摘要
目的:本研究旨在评估仰卧位侧位x线片(SLRs)是否可以替代应力x线片诊断慢性后交叉韧带(PCL)损伤和鉴别合并后交叉韧带损伤(定义为PCL损伤合并内侧副韧带或后外侧韧带复合损伤)。方法:在本回顾性研究中，对慢性PCL损伤患者(n = 38)进行30°和90°膝关节屈曲处的SLRs (30/90 SLRs)和Telos应力片拍摄，而健康对照(n = 84)仅拍摄30/90 SLRs。在30/90单反和应力片上评估损伤与正常的差异。通过相关分析评价慢性PCL损伤患者30/90 slr和应激x线片损伤与正常的差异。进行亚组分析，比较单独和联合PCL损伤组在30/90 slr和应力片上的损伤与正常的差异。计算基于30/90 slr的受者工作特征曲线，确定诊断慢性PCL损伤和鉴别合并PCL损伤的截止值。结果:30张SLRs与90张SLRs的损伤与正常的差异(3.1±3.6 vs 1.6±1.2,P = 0.019)和90张SLRs的损伤与正常的差异(7.5±3.5 vs 1.2±1.0,P = 0.019)结论:90张SLRs对慢性PCL损伤的诊断准确性与应力片相似。因此，当应力x线片不可用时，90slr是评估膝关节后部松弛度的可靠替代方法。证据等级:四级，案例系列。
Supine lateral radiographs at 90° of knee flexion have a similar diagnostic accuracy for chronic posterior cruciate ligament injuries as stress radiographs.
Purpose: This study aimed to evaluate whether supine lateral radiographs (SLRs) could replace stress radiographs for diagnosing chronic posterior cruciate ligament (PCL) injuries and identifying combined PCL injuries (defined as PCL injury with medial collateral ligament or posterolateral ligament complex injury).
Methods: In this retrospective study, both SLRs at 30° and 90° of knee flexion (30/90 SLRs) and Telos stress radiographs of patients with chronic PCL injuries (n = 38) and only 30/90 SLRs of healthy controls (n = 84) were taken. Injured-to-normal differences on 30/90 SLRs and stress radiographs were assessed. Correlation analysis was performed to evaluate injured-to-normal differences on 30/90 SLRs and stress radiographs in patients with chronic PCL injury. Subgroup analysis was performed to compare injured-to-normal differences on 30/90 SLRs and stress radiographs between the isolated and combined PCL injury groups. Receiver operating characteristic curves based on 30/90 SLRs were calculated to determine the cut-off value for diagnosing chronic PCL injury and identifying combined PCL injury.
Results: Injured-to-normal differences on both 30 SLRs (3.1 ± 3.6 vs 1.6 ± 1.2, P = 0.019) and 90 SLRs (7.5 ± 3.5 vs 1.2 ± 1.0, P < 0.001) were significantly greater in patients with chronic PCL injuries than in healthy controls. Further, 90 SLRs had a highly accurate diagnostic value for chronic PCL injuries (area under the curve 0.958). The cut-off value for diagnosing chronic PCL injuries based on 90 SLRs was 3.0 mm (sensitivity, 94.7%; specificity, 92.9%). Injured-to-normal differences on 30/90 SLRs were significantly correlated with those on stress radiographs. The correlation coefficients were 0.397 (P = 0.014) for 30 SLRs and 0.605 (P < 0.001) for 90 SLRs. The cut-off value for diagnosing combined PCL injuries based on 90 SLRs was 9.6 mm (area under the curve 0.72).
Conclusions: The diagnostic accuracy of 90 SLRs for chronic PCL injuries was similar to that of stress radiographs. Therefore, the 90 SLRs are reliable alternative method to assess the posterior knee laxity when the stress radiographs are not available.
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