前交叉韧带损伤患者胫骨平台后倾角不同测量方法比较

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摘要目的比较不同方法测量膝关节前交叉韧带(anterior cruciate ligament，ACL)损伤患者胫骨平台后倾角(posterior tibial slope，PTS)的差异。方法纳入2019年1月至2020年12月在中南大学湘雅医院骨科接受ACL重建术的91例患者进行回顾性分析，男性72例，女性19例，平均年龄(29.23±7.36)岁。两名研究者独立在术后膝关节侧位X线片上分别采用解剖轴法、后皮质轴法和前皮质轴法测量PTS，比较不同测量方法的稳定性。结果采用解剖轴法测得PTS均值为(10.63±3.60) °，后皮质轴法测得PTS均值为(9.05±3.74) °，前皮质轴法测得PTS均值为(13.28±3.57) °。配对样本t检验比较三种测量方法，结果差异有统计学意义(P＜0.01)；独立样本t检验比较，三种测量方法组内男女性之间的PTS差异，结果显示解剖轴法和前皮质轴法测量的PTS组内男女之间比较，差异无统计学意义(P＞0.05)；后皮质轴法测量的PTS男女之间比较，差异有统计学意义(P＜0.05)。后皮质轴测量PTS方法组内相关系数(intraclass correlation coeficient，ICC)为0.953，组间一致性ICC为0.882，在三种不同测量方法中最高。结论后皮质轴法测量PTS的稳定性最高，推荐临床使用。

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	田阳婧

关键词 ：膝关节, 胫骨平台后倾角, 前交叉韧带, 测量方法

Abstract：Objective To compare the difference of the posterior tibial slope (PTS) in patients with anterior cruciate ligament (ACL) injury measured by different methods.Methods A retrospective analysis was carried out on 91 patients who underwent ACL reconstruction in the Department of Orthopaedics of Xiangya Hospital in Central South University from January 2019 to December 2020.The research included 72 males and 19 females，with an average age of (29.23±7.36) years.Two researchers independently measured the PTS using the proximal anatomic axis，the posterior tibial cortex axis and the anterior tibial cortex axis on the lateral Xray of the knee joint after the operation，and compared the stability of the results of different measurement methods.Results The mean PTS measured by the proximal anatomic axis was (10.63±3.60) °，the mean PTS measured by the posterior cortex axis was (9.05±3.74) °，and the mean PTS measured by the anterior cortex axis was (13.28±3.57) °.The paired sample t test compared the results of three measurement methods，and there was a statistical difference between them (P＜0.01).The independent sample ttest was used to compare the PTS between male and female patients，and the results showed that there was no statistical difference in the PTS measured by the proximal anatomic axis and the anterior tibial cortex axis method(P＞0.05)，while there was a statistical difference in the PTS measured by the posterior tibial cortex axis method (P＜0.05).The intraclass correlation coefficient (ICC) of the posterior tibial cortex axis for measuring the PTS was 0.953 within-group and 0.882 between-group，which were both the highest among the three different methods.Conclusion The posterior cortex axis method has the highest stability in measuring the posterior tibial slope and is recommended for clinical use.

Key words： knee joint posterior tibial slope anterior cruciate ligament measuring method

通讯作者: 田阳婧

作者简介: 徐备(1986－ )，男，主治医师，中南大学湘雅医院骨科，409827388@qq.com

引用本文:

徐备，田阳婧. 前交叉韧带损伤患者胫骨平台后倾角不同测量方法比较[J]. 实用骨科杂志, 2023, 29(8): 694-.
Xu Bei，Tian Yangjing. Comparison of Different Measurement Methods of Posterior Tibial Slope Inclination in Patients with Anterior Cruciate Ligament Injury. sygkzz, 2023, 29(8): 694-.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I8/694

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