| Objective:To investigate wh ether the rapture of ACL will cause the ch ange of anatomic form of the af fected side femoral intercondylar fossa, explain its correlation with ACL rapture disease course and m otor function score and provide reference for the formulation of operation plan for patients with ACL rapture in clinical work.The relationship between the ACL rapture and fem oral intercondylar fossa has been studied by many scholars and explained in m any articles. The results of abundant research have verified that th e congenital stenosis of femoral intercondylar fossa will great ly enhance the possibility of ACL injury[1-2];however, few people have ever studied wheth er the femoral intercondylar fossa will undergo secondary hyperplasia stenosis after the ACL rapture[3]. The fossa intercondyl oidea in previ ous studies was measured through X-ray or CT; as the front of fossa intercondyloi dea is covered by cartilage, it is dif ficult for X-ray and CT images to correctly displa y the anatomic form of fossa intercondyloidea; however, it is worth-noticing that the X-ray and CT have poor imaging effect for soft tissue and ligament. However, MRI soft tissue has good imaging capacity with higher resoluti on ratio; for this reason, it is used for the appropriat e differentiation of all the results and possessed of advantages in clinical application[4-5]. The M RI imaging quantitative detection means is adopted in this re search to expound on the relationship between ACL rapture and the change of anatomic form of femoral intercondylar fossa(including ICW, ICH, EW, NSI and NWI), analyze the correlation between the cha nge of anatom ic form of fem oral intercondylar fossa and ACL rapture disease course and knee motor function score(Lysholm score and Tegner score) and provide reference for risk assessment, selection of appropriate operation plan and postoperative treatment pred iction of patients with clinical ACL rapture.Methods:The clinical data of 120 cases of patients with unilateral knee ACL rapture diagnosed by knee arthroscopy fr om July 2013 to Oct ober 2014 were collected with the corresponding treatment measures taken according t o their injury severity. Among them, the clinical data of 40 cases of patients without degeneration in the knee examined by X-ray were also studied. The patients selected met the i nclusion criteria and exclusion criteria of this research. Among the 40 patients, 28 we re males and 12 females with their age ranging from 22 to 51 and t he average of(35.68 ±9.85). The rapturing tim e for the ACL of affected knee ranged from 6 to 71 months with the average ti me of(32.4±18.25); there were16 cases with ACL rapture in the left knee and 24 in the right. The af fected knees were taken as the observation group and the unaffected knee of the same patient as the control group. This research has been approved by t he Ethics Comm ittee of our hospi tal and obtai ned the informed consent right from the patients and their family members. Before the operation, the af fect knee ACL rapture disease course of the patients was recorded and the NMR of bilateral kne e femoral intercondylar fossa taken. Meanwhile, the relevant parameters of double knees fem oral intercondylar fossa were measured, including the EW, ICW, ICH so as to calculate NSI and NWI and assess the L ysholm score and Tegner score of the af fected knees of different patients. To discuss: 1. the difference between the m orphological parameters of the fem oral intercondylar fossa of the unaf fected and affected knees. 2. the corelation between the fossa intercondyloidea stenosis degree and disease course. 3. the correlatio n between the fossa intercondyloidea stenosis degree and corresponding m otor function score. The measured value of each group was examined with t and the measured data analyzed with Pearson method.Results:1.The average value of ICWs in observation group was(14.50±0.88)mm. The average value of ICWs in contro l group was(17.19±1.83)mm. ICWs in observation group were smaller than those in control group and the difference had statistical significance(t=-8.369,P<0.001).2.The average value of ICHs in observation group was(20.78±1.69)mm. The average value of ICHs in cont rol group was(21.29±1.71)mm. The difference in ICH between the two gr oups had no statisti cal significance(t=-1.356,P=0.179).3.The average value of EWs in observation group was( 74.42±2.39)mm. The average value of EWs in c ontrol group was(74.92±2.42)mm. The difference in EW between the two gr oups had no statistical significance(t=-0.936,P=0.352).4.The average value of NSIs in obs ervation group was( 0.20±0.01). The average value of NSIs in control group was(0.23±0.03). The NSIs in observation group were sm aller than those in control group and their difference had statistical significance(t=-7.213,P<0.001).5.The average value of NWIs in obs ervation group was(0.70±0.08). The average value of NWIs in control gr oup was(0.81±0.13). The NWIs in observation group were sm aller than those in control group and their difference had statistical significance(t=-4.770;P<0.001).6. The average deviation of ICWs(the healthy si de-the injured side) of the same patients was(2.69±1.56)mm. Th e average time of ruptured ACL in injured knees was(32.40±18.25) months. The correlation analysis between the two had statistical significance( r=0.951,P<0.001). The longer the time of ruptured ACL, the bigger the differences between the ICWs.7.The average L ysholm score for in jured knees was(46.32±6.62).Theaverage Tegner score was(4.37±1.19). The correlation anal ysis betweenLysholm score, Tegner score and stenosis degree of intercondylar fossa hadno statistical significance(r=-0.049,P>0.05; r=-0.123,P>0.05).Conclusions:After the rupture of ACL, stenosis occurs to the ICW of the injured femur; at the meantime, the NSI and NWI decreas e. Their stenosis deteriorates with the increment in the course of ruptur ed ACL.There is no relationship between the Lyscholom score and T egner score of patients with varied degrees of stenosis in the intercondylar fossa. |
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