前交叉韧带损伤患者中Kaplan纤维损伤与胫骨前外侧半脱位的关联性研究
简介
本研究纳入132例急性ACL损伤患者，通过MRI评估Kaplan纤维（KF）、前外侧韧带（ALL）完整性及外侧间室胫骨前移（ATSLC）。发现KF损伤患者（占35.6%）的ATSLC显著增加，且KF损伤独立解释了15.1%的胫骨前移变异（P<0.001）；在合并前外侧复合体损伤的患者中，股骨外侧髁宽度比增大是重度前移（≥4.5 mm）的独立预测因素。提示KF…
英文摘要
BACKGROUND: Kaplan fibers (KFs) are critical stabilizers of the knee, yet their role in anterior tibial subluxation of the lateral compartment (ATSLC) in anterior cruciate ligament (ACL) injury remains unclear. This study is to determine whether KF injury is independently associated with increased ATSLC on magnetic resonance imaging (MRI) in patients with an injured ACL, and to identify risk factors for high-grade ATSLC (≥ 4.5 mm). PATIENTS AND METHODS: This retrospective study enrolled 132 patients with ACL injury who underwent MRI within 12 weeks of trauma. MRI was used to evaluate the integrity of the ACL, KFs, anterolateral ligament (ALL), bony morphology, and ATSLC. Two trained observers independently assessed all images using standardized criteria. Agreement between observers was calculated using standard reliability metrics. Multivariable linear regression was performed to evaluate the independent association between KF injury and ATSLC. Logistic regression and receiver operating characteristic analysis were used to identify predictors of high-grade anterior tibial subluxation (≥ 4.5 mm) in patients with combined ACL and anterolateral complex injuries. RESULTS: Of the 132 patients, 35.6% had KF injuries. These patients exhibited higher rates of ALL injury and distinct bony morphologic features. KF injury independently explained 15.1% of anterior tibial subluxation variability (P < 0.001). In patients with combined anterolateral complex injuries, increased lateral femoral condyle width ratio was identified as an independent predictor of high-grade subluxation. DATA CONCLUSION: KF injury is independently associated with greater anterior tibial subluxation, suggesting a key role in post-traumatic knee instability. Specific femoral anatomical feature may further predict high-risk cases. LEVEL OF EVIDENCE: Level IV.