孙英华^1,,
任金亭²,
王莉¹,
于永杰¹,
苑广科¹,
焦兆德¹,
方军¹,
李建民^3,,
1. 潍坊医学院附属益都中心医院 骨科, 山东 潍坊 262500
2. 青州市红十字会, 山东 潍坊 262500
3. 山东大学齐鲁医院 骨科, 山东 济南 250012

基金项目: 山东省医药卫生科技发展计划（2018WS075）；潍坊市卫生计生委科研项目计划（2017WSJS049）


详细信息 作者简介: 孙英华(1976-), 男, 副主任医师。E-mail: qzydsyh@163.com








通讯作者: 李建民, 教授。E-mail: gkljml@163.com 中图分类号: R684.7


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。
关键词: 年龄相关/
胫骨平台后倾角/
前交叉韧带/
损伤


Abstract:ObjectiveTo investigate age-related changes of posterior tibial slope (PTS) and its roles in noncontact anterior cruciate ligament (ACL) injury.MethodsPositive 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.ResultsThe 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.ConclusionThe 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.
Keywords:age-related/
posterior tibial slope/
anterior cruciate ligament/
injury

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