年龄相关胫骨平台后倾角变化规律及与前交叉韧带损伤的关系

Age-related changes of posterior tibial slope and its roles in anterior cruciate ligament injury

关键词:  年龄相关  胫骨平台后倾角  前交叉韧带  损伤

Key words:  age-related  posterior tibial slope  anterior cruciate ligament  injury

摘要:

目的 探讨年龄相关胫骨平台后倾角（posterior tibial slope，PTS）变化规律及其与非接触性前交叉韧带（anterior cruciate ligament，ACL）损伤之间的关系。方法 1 431例膝正侧位X线片按标准纳入，每10岁间隔分组，共分0~<10岁到≥ 80岁9组，测量各组PTS值，并根据年龄、性别、侧别及ACL损伤情况分别进行比较。采用t检验、方差分析、曲线拟合等统计方法分析数据。结果 PTS值在0~<10岁、30~<40岁组男性大于女性，而在40~<50岁、60~<70岁、70~<80岁、≥ 80岁组男性小于女性；在0~<10岁、10~<20岁、50~<60岁、60~<70岁、≥ 80岁组左侧大于右侧；拟合曲线呈现随年龄增长先降后升的变化趋势，曲线波谷在40~60岁年龄段；在20~<30岁、30~<40岁、40~<50岁组ACL损伤膝大于无损伤膝，而在50~<60岁组ACL损伤膝与无损伤膝差别无统计学意义。结论 PTS值随年龄增长呈现先降后升的变化趋势，在运动活跃年龄段PTS值增加会增加非接触性ACL损伤的风险，但随年龄增长风险逐渐降低。

Abstract:

Objective To investigate age-related changes of posterior tibial slope (PTS) and its roles in noncontact anterior cruciate ligament (ACL) injury. Methods Positive and lateral knee X-ray films of 1 431 cases were included based on the availability of lateral radiographs and a suitable femoro-tibial angle. The cases were divided into 9 groups from 0-<10 years to ≥ 80 years by 10-year age intervals.The PTS values of each group were measured and compared according to age, gender, side, and injury status. Student's t-tests, one-way analysis of variance, and curve fitting were used to analyze the data. Results The PTS values in male were greater than those in female in the 0-<10 and 30-<40 years old groups, but this pattern reversed in the 40-<50, 60-<70, 70-<80, and ≥ 80 years old groups. The PTS values were greater on the left side than those on the right side in the 0-<10, 10-<20, 50-<60, 60-<70, and ≥ 80 years old groups. The curve fitting for PTS demonstrated a trend of initial decrease followed by increase with aging, with a trough of the curve appearing in the 40-60 years old age. The PTS values were significantly different between knees with and without ACL injury in the 20-<30, 30-<40, and 40-<50 years old groups, but not in the 50-<60years old group. Conclusion The PTS follows a trend of initial decrease and then increase.The increase of PTS values will increase the risk of noncontact ACL injury in activity crowd. However, the risk will gradually decrease with advancing age.