前交叉韧带损伤患者侧位片上股骨外侧髁形态的不同定量测量方法之间没有临床相关性。

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2024-11-04 DOI:10.1002/jeo2.70078

Steffen T. Ubl, Johannes C. Harmes, Evamaria Koch, Arasch Wafaisade, Daniel Guenther, Bertil Bouillon, Thomas R. Pfeiffer

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引用次数: 0

摘要

目的：明确在侧位X光片上量化股骨外侧髁（LFC）骨形态作为前交叉韧带（ACL）损伤风险因素的不同方法是否应被视为个体风险因素，并评估观察者之间和观察者内部的可靠性：我们回顾性地检查了在本院接受初级前交叉韧带重建术的 487 例患者。我们利用受伤膝关节的常规侧位X光片测量了以下参数：LFC比率（LFCR）、LFC高度与前胸直径比率（HAPR）、股骨与胫骨尺寸比率（FTSR）、胫骨与股骨后髁比率（TPFCR）和Porto比率（XY/AB；B/AB；B/XY）。畸形X光片被排除在外。采用皮尔逊相关系数来确定两者之间的关系。对两名评分者的观察者间和观察者内可靠性计算类内相关系数：结果：共纳入 58 名患者。LFCR 的平均值和标准差为 63.7% ± 2.8%，HAPR 为 0.35 ± 0.02，FTSR 为 1.23 ± 0.07，TPFCR 为 2.99 ± 0.28，XY/AB 为 0.41 ± 0.08，B/AB 为 1.20 ± 0.06，B/XY 为 3.05 ± 0.58。在 FTSR 与 XY/AB（r = 0.425）、B/AB（r = 0.582）和 TPFCR（r = -0.326）之间、XY/AB 与 HAPR（r = -0.309）和 B/XY （r = -0.933）之间以及 TPFCR 与 B/AB （r = 0.302）之间观察到显著的相关性。LFCR、HAPR、FTSR、TPFCR 和 B/AB 的观察者内一致性极佳，XY/AB 和 B/XY 的观察者内一致性良好。XY/AB和B/XY的观察者间一致性较差，HAPR、B/AB、FTSR和TPFCR的观察者间一致性较好，而LFCR的观察者间一致性极佳：结论：不同的 LFC 骨形态量化方法应被视为个体风险因素，其特点是观察者内部可靠性良好到极佳，但观察者之间的可靠性差异很大：证据等级：三级

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No clinically relevant relationship between different quantitative measurement methods of the lateral femoral condyle morphology on lateral radiographs in anterior cruciate ligament-injured patients

Purpose

To clarify whether different methods of quantifying lateral femoral condyle (LFC) bone morphology as risk factors for anterior cruciate ligament (ACL) injury on lateral radiographs should be considered as individual risk factors and to assess inter- and intraobserver reliability.

Methods

We retrospectively reviewed 487 patients undergoing primary ACL reconstruction at our institution. Routine lateral radiographs of the injured knees were utilized to measure the following parameters: LFC ratio (LFCR), height of LFC to anteroposterior diameter ratio (HAPR), femur tibia size ratio (FTSR), tibia to posterior femoral condyle ratio (TPFCR) and Porto ratios (XY/AB; B/AB; B/XY). Malrotated radiographs were excluded. Pearson's correlation coefficients were used to identify relationships. Intraclass correlation coefficients were calculated for inter- and intraobserver reliability for two raters.

Results

Fifty-eight patients were included. Means and standard deviations for LFCR were 63.7% ± 2.8%, HAPR 0.35 ± 0.02, FTSR 1.23 ± 0.07, TPFCR 2.99 ± 0.28, XY/AB 0.41 ± 0.08, B/AB 1.20 ± 0.06 and B/XY 3.05 ± 0.58. Significant correlations were observed between FTSR and XY/AB (r = 0.425), B/AB (r = 0.582) and TPFCR (r = −0.326), between XY/AB and HAPR (r = −0.309) and B/XY (r = −0.933) and between TPFCR and B/AB (r = 0.302). Intraobserver agreement was excellent for LFCR, HAPR, FTSR, TPFCR and B/AB and good for XY/AB and B/XY. Interobserver agreement varied from poor for XY/AB and B/XY, good for HAPR, B/AB, FTSR and TPFCR to excellent for LFCR.

Conclusion

Different methods of quantifying LFC bone morphology should be considered as individual risk factors, characterized by good to excellent intraobserver reliability, but highly variable interobserver reliability.