Investigation of the Effect of the Joint Line to Anterior Cruciate Ligament Injuries with Radiographs
Öz
Objective: Knee joint arthroplasty is the operation performed in the clinic due to advanced osteoarthritis. It has been determined in the literature that patients with anterior cruciate ligament (ACL) injuries may develop osteoarthritis when conservative treatment is applied instead of invasive methods. The aim of our study was determined as evaluating the results by gender, side and between groups by making joint line measurements in the patient group with ACL injuries, which are not included in the literature.
Material and Methods: Measurements of the Joint Line Medial (JL / Med.) and Joint Line Lateral (JL / Lat.) Parameters in the knee joint by using the radiographs of the ACL operation and control groups; It was carried out by considering gender and side differences. Tuberculum adductorium was used as a reference structure for measurements. The ACL group consists of 15 women / 143 men. The control group consists of 150 women / 150 men. In the patient group with ACL operation, the average age is 28.46 (range 16-48), and the average age in the control group is 32.96 (range 16-50).
Results: The mean JL / Med parameter was 43.3 ± 4.7, 44.5 ± 4.7 mm in the ACL group women; 49.8 ± 4.7, 50.1 ± 4.0 mm in men, respectively, on the right and left sides. The mean JL / Med parameter was 46.4 ± 4.2, 46.1 ± 3.5 mm in the control group women; 52.9 ± 4.0, 52.8 ± 3.9 mm in men, respectively, on the right and left sides. The mean JL / Med parameter was 41.7 ± 4.5, 42.8 ± 4.2 in the ACL group women; 46.7 ± 4.4, 47.8 ± 3.7 mm in men, respectively, on the right and left sides The mean JL / Lat parameter was 44.1 ± 3.6, 45.3 ± 3.9 mm in the control group women; 50.1 ± 4.4, 51.3 ± 4.1 mm in men, respectively, on the right and left sides.
Conclusion: It was concluded that there were statistically significant differences in terms of gender and sides, and the joint line distances were higher in the control group, so narrow joint line could be ACL injuries. We think that with our study, we can contribute to the literature and clinicians.
Anahtar Kelimeler
Anterior cruciate ligament joint line knee joint adductor tubercle
Kaynakça
- Barnett, A.J., Howells, N.R., Burston, B.J., Ansari, A., Clark, D., Eldridge, J.D. (2012). Radiographic landmarks for tunnel placement in reconstruction of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-011-1871-8
- Christiansen, S.E., Jacobsen, B.W., Lund, B., Lind, M. (2008). Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes. Arthroscopy 24:82–87.
- Gürbüz, H., Çakar, M., Adaş, M., Tekin, A. Ç., Bayraktar, M. K., & Esenyel, C. Z. (2015). Measurement of the knee joint line in Turkish population. Acta orthopaedica et traumatologica turcica, 49(1), 41–44. https://doi.org/10.3944/AOTT.2015.14.0050
- Griffin, F. M., Math, K., Scuderi, G. R., Insall, J. N., Poilvache, P. L. (2000). Anatomy of the epicondyles of the distal femur: MRI analysis of normal knees. The Journal of Arthroplasty, 15(3):354-359. DOI: 10.1016/s0883-5403(00)90739-3.
- Hofmann, A. A., Kurtin, S. M., Lyons, S., Tanner, A. M., & Bolognesi, M. P. (2006). Clinical and radiographic analysis of accurate restoration of the joint line in revision total knee arthroplasty. The Journal of Arthroplasty, 21(8), 1154–1162. https://doi.org/10.1016/j.arth.2005.10.026
- Iacono, F., Lo Presti, M., Bruni, D., Raspugli, G. F., Bignozzi, S., Sharma, B., & Marcacci, M. (2013). The adductor tubercle: a reliable landmark for analysing the level of the femorotibial joint line. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 21(12), 2725–2729. https://doi.org/10.1007/s00167-012-2113-4
- Jacobi, M., Reischl, N., Bergmann, M., Bouaicha, S., Djonov, V., Magnussen, R.A. (2012). Reconstruction of the medial patellofemoral ligament using the adductor magnus tendon: an anatomic study. Arthroscopy, 28:105–109
- Lind, M., Jakobsen, B.W., Lund, B., Christiansen, S.E. (2008). Reconstruction of the medial patellofemoral ligament for treatment of patellar instability. Acta Orthop, 79:354–360
- Maderbacher, G., Keshmiri, A., Schaumburger, J., Springorum, H. R., Zeman, F., Grifka, J., & Baier, C. (2014). Accuracy of bony landmarks for restoring the natural joint line in revision knee surgery: an MRI study. International orthopaedics, 38(6), 1173–1181. https://doi.org/10.1007/s00264-014-2292-3
- Romero, J., Seifert, B., Reinhardt, O., Ziegler, O., & Kessler, O. (2010). A useful radiologic method for preoperative joint-line determination in revision total knee arthroplasty. Clinical orthopaedics and related research, 468(5), 1279–1283. https://doi.org/10.1007/s11999-009-1114-1
- Servien, E., Viskontas, D., Giuffrè, B. M., Coolican, M. R., & Parker, D. A. (2008). Reliability of bony landmarks for restoration of the joint line in revision knee arthroplasty. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 16(3), 263–269.
- Tokuhara, Y., Kadoya, Y., Nakagawa, S. (2004). The flexion gap in normal knees. An MRI study. J Bone Joint Surg, 86: 1133. von Porat, A., Roos, E.M., Roos, H (2004). High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Annals of the Rheumatic Diseases, 63:269-273.
- Yeh, K., Chen, I., Wang, C. et al (2019). The adductor tubercle can be a radiographic landmark for joint line position determination: an anatomic-radiographic correlation study. J Orthop Surg Res, 14: 189. https://doi.org/10.1186/s13018-019-1221-y
Ligamentum Cruciatum Anterius Yaralanmalarında Eklem Hattı Etkisinin Radyolojik Görüntüler ile Araştırılması
Öz
Amaç: Diz eklemi artroplastisi ileri düzey osteoartrit sebebiyle klinikte gerçekleştirilen operasyonlardır. Ligamentum cruciatum anterius (LCA) yaralanmalı hastalarda girişimsel yöntemler yerine konservatif tedavi uygulandığında osteoartrit gelişebileceği literatür ile belirlenmiştir. Yaptığımız çalışmanın amacı literatürde yer almayan LCA yaralanmalı hasta grubunda eklem hattı ölçümleri yaparak, sonuçları cinsiyet, taraf ve gruplar arası değerlendirmek olarak belirlenmiştir.
Gereç ve Yöntem: LCA operasyonu olan ve kontrol gruplarının radyografik görüntüleri üzerinden diz eklemindeki Eklem Hattı Medial (EH/Med.) ve Eklem Hattı Lateral (EH/Lat.) parametrelerinin ölçümleri; cinsiyet ve taraf farkı gözetilerek gerçekleştirilmiştir. Ölçümlerde referans yapı olarak tuberculum adductorium kullanılmıştır. LCA grubu 15 kadın/143 erkek’ten oluşmaktadır. Kontrol grubu 150 kadın/150 erkek’ten oluşmaktadır. LCA operasyonu olan hasta grubunda yaş ortalaması 28.46 (16-48 aralığında), kontrol grubu yaş ortalaması ise 32.96 (16-50 aralığında)’dır.
Bulgular: EH/Med parametresi LCA grubu kadınlarda ortalama 43.3±4.7, 44.5±4.7; erkeklerde 49.8±4.7, 50.1±4.0 mm olmak üzere sırasıyla sağ ve sol taraf değerleri belirlenmiştir. EH/Med parametresi kontrol grubu kadınlarda ortalama 46.4±4.2, 46.1±3.5; erkeklerde 52.9±4.0, 52.8±3.9 mm olmak üzere sırasıyla sağ ve sol taraf değerleri belirlenmiştir. EH/Lat parametresi LCA grubu kadınlarda ortalama 41.7±4.5, 42.8±4.2; erkeklerde 46.7±4.4, 47.8±3.7 mm olmak üzere sırasıyla sağ ve sol taraf değerleri belirlenmiştir. EH/Lat parametresi kontrol grubu kadınlarda ortalama 44.1±3.6, 45.3±3.9; erkeklerde 50.1±4.4, 51.3±4.1 mm olmak üzere sırasıyla sağ ve sol taraf değerleri belirlenmiştir.
Sonuç: Cinsiyet ve taraf açısından istatistiksel olarak anlamlı farkların olduğu, eklem hattı mesafelerinin kontrol grubunda daha yüksek oluşu sebebiyle eklem hattı darlığının LCA yaralanması riskine sebep olabileceği sonucuna ulaşılmıştır. Yaptığımız çalışma ile literatüre ve klinisyenlere katkı sağlanabileceğini düşünmekteyiz.
Anahtar Kelimeler
ligamentum cruciatum anterius eklem hattı diz eklemi tuberculum adductorium
Kaynakça
- Barnett, A.J., Howells, N.R., Burston, B.J., Ansari, A., Clark, D., Eldridge, J.D. (2012). Radiographic landmarks for tunnel placement in reconstruction of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-011-1871-8
- Christiansen, S.E., Jacobsen, B.W., Lund, B., Lind, M. (2008). Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes. Arthroscopy 24:82–87.
- Gürbüz, H., Çakar, M., Adaş, M., Tekin, A. Ç., Bayraktar, M. K., & Esenyel, C. Z. (2015). Measurement of the knee joint line in Turkish population. Acta orthopaedica et traumatologica turcica, 49(1), 41–44. https://doi.org/10.3944/AOTT.2015.14.0050
- Griffin, F. M., Math, K., Scuderi, G. R., Insall, J. N., Poilvache, P. L. (2000). Anatomy of the epicondyles of the distal femur: MRI analysis of normal knees. The Journal of Arthroplasty, 15(3):354-359. DOI: 10.1016/s0883-5403(00)90739-3.
- Hofmann, A. A., Kurtin, S. M., Lyons, S., Tanner, A. M., & Bolognesi, M. P. (2006). Clinical and radiographic analysis of accurate restoration of the joint line in revision total knee arthroplasty. The Journal of Arthroplasty, 21(8), 1154–1162. https://doi.org/10.1016/j.arth.2005.10.026
- Iacono, F., Lo Presti, M., Bruni, D., Raspugli, G. F., Bignozzi, S., Sharma, B., & Marcacci, M. (2013). The adductor tubercle: a reliable landmark for analysing the level of the femorotibial joint line. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 21(12), 2725–2729. https://doi.org/10.1007/s00167-012-2113-4
- Jacobi, M., Reischl, N., Bergmann, M., Bouaicha, S., Djonov, V., Magnussen, R.A. (2012). Reconstruction of the medial patellofemoral ligament using the adductor magnus tendon: an anatomic study. Arthroscopy, 28:105–109
- Lind, M., Jakobsen, B.W., Lund, B., Christiansen, S.E. (2008). Reconstruction of the medial patellofemoral ligament for treatment of patellar instability. Acta Orthop, 79:354–360
- Maderbacher, G., Keshmiri, A., Schaumburger, J., Springorum, H. R., Zeman, F., Grifka, J., & Baier, C. (2014). Accuracy of bony landmarks for restoring the natural joint line in revision knee surgery: an MRI study. International orthopaedics, 38(6), 1173–1181. https://doi.org/10.1007/s00264-014-2292-3
- Romero, J., Seifert, B., Reinhardt, O., Ziegler, O., & Kessler, O. (2010). A useful radiologic method for preoperative joint-line determination in revision total knee arthroplasty. Clinical orthopaedics and related research, 468(5), 1279–1283. https://doi.org/10.1007/s11999-009-1114-1
- Servien, E., Viskontas, D., Giuffrè, B. M., Coolican, M. R., & Parker, D. A. (2008). Reliability of bony landmarks for restoration of the joint line in revision knee arthroplasty. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 16(3), 263–269.
- Tokuhara, Y., Kadoya, Y., Nakagawa, S. (2004). The flexion gap in normal knees. An MRI study. J Bone Joint Surg, 86: 1133. von Porat, A., Roos, E.M., Roos, H (2004). High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Annals of the Rheumatic Diseases, 63:269-273.
- Yeh, K., Chen, I., Wang, C. et al (2019). The adductor tubercle can be a radiographic landmark for joint line position determination: an anatomic-radiographic correlation study. J Orthop Surg Res, 14: 189. https://doi.org/10.1186/s13018-019-1221-y
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 29 Ocak 2021 |
| Gönderilme Tarihi | 10 Kasım 2020 |
| Kabul Tarihi | 14 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 2 Sayı: 1 |
Turkish Journal of Science and Health (TFSD)
E-mail: tfsdjournal@gmail.com
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