nach oben

Erschienen in:

10.04.2023 | Scientific Article

Comparisons of diagnostic performance and the reliability in identifying ACL injury between two measuring protocols of anterior tibial subluxation on MR images

verfasst von: Zhi-yu Zhang, Hong-jie Huang, Pakezhati Maimaitijiang, Xiao-yu Pan, Xiao-yue Fu, Cheng Wang, Jian-quan Wang

Erschienen in: Skeletal Radiology | Ausgabe 9/2023

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate the diagnostic performance in identifying an anterior cruciate ligament (ACL) injury and the reliability between two measuring protocols of anterior tibial subluxation (ATS).

Materials and methods

A total of 165 patients with ACL injury and 157 ACL-intact patients were included in this study. Two different measuring protocols of ATS were performed on sagittal MR images, including the modified protocol using the longitudinal tibial axis (axis protocol) and the established protocol using a line perpendicular to the tibial plateau (plateau protocol). Receiver-operating characteristic (ROC) curves were calculated to evaluate the diagnostic performance in identifying an ACL injury, and areas under the curves (AUCs) were compared between the two protocols. Intra- and interobserver reliability tests were performed to evaluate the reliability of the measurements.

Results

Lateral ATS (P < 0.001) and medial ATS (P < 0.001) were increased in patients with ACL injury under both protocols. To identify an ACL injury, ATS measured under the axis protocol showed higher AUC values than the plateau protocol, including lateral ATS (AUC 0.828 vs. 0.688, P < 0.001), medial ATS (AUC 0.829 vs. 0.789, P = 0.013), and the combined indicator of lateral and medial ATS (AUC 0.885 vs. 0.810, P < 0.001). Reliability tests showed that both protocols were reliable.

Conclusions

ATS measured under the modified protocol using the longitudinal tibial axis showed superior diagnostic performance in identifying an ACL injury compared to the established protocol, indicating that the modified protocol may better reflect the characteristics of an ACL-deficient knee.

Gornitzky AL, Lott A, Yellin JL, Fabricant PD, Lawrence JT, Ganley TJ. Sport-specific yearly risk and incidence of anterior cruciate ligament tears in high school athletes: a systematic review and meta-analysis. Am J Sports Med. 2016;44(10):2716–23.CrossRefPubMed

Daniel DM, Stone ML, Sachs R, Malcom L. Instrumented measurement of anterior knee laxity in patients with acute anterior cruciate ligament disruption. Am J Sports Med. 1985;13(6):401–7.CrossRefPubMed

McDonald LS, van der List JP, Jones KJ, Zuiderbaan HA, Nguyen JT, Potter HG, et al. Passive anterior tibial subluxation in the setting of anterior cruciate ligament injuries: a comparative analysis of ligament-deficient states. Am J Sports Med. 2017;45(7):1537–46.CrossRefPubMed

Hardy A, Klouche S, Szarzynski P, Charpentier E, Beranger JS, Bauer T, et al. A threshold value of 3.5mm of passive anterior tibial subluxation on MRI is highly specific for complete ACL tears. Knee Surg Sports Traumatol Arthrosc. 2019;27(3):885–92.CrossRefPubMed

Zhang ZY, Wang C, Maimaitimin M, Huang HJ, Pan XY, Maimaitijiang P, et al. Anterior and rotational tibial subluxation in the setting of anterior cruciate ligament injuries: an MRI analysis. Knee. 2021;33:365–73.CrossRefPubMed

Grassi A, Macchiarola L, Barrientos FU, Zicaro JP, Paz MC, Adravanti P, et al. Steep posterior tibial slope, anterior tibial subluxation, deep posterior lateral femoral condyle, and meniscal deficiency are common findings in multiple anterior cruciate ligament failures: an MRI case-control study. Am J Sports Med. 2019;47(2):285–95.CrossRefPubMed

Song GY, Zhang H, Zhang J, Zhang ZJ, Zheng T, Feng H. Excessive preoperative anterior tibial subluxation in extension is associated with inferior knee stability after anatomic anterior cruciate ligament reconstruction. Am J Sports Med. 2020;48(3):573–80.CrossRefPubMed

Tanaka MJ, Jones KJ, Gargiulo AM, Delos D, Wickiewicz TL, Potter HG, et al. Passive anterior tibial subluxation in anterior cruciate ligament-deficient knees. Am J Sports Med. 2013;41(10):2347–52.CrossRefPubMed

Nishida K, Matsushita T, Araki D, Sasaki H, Tanaka T, Hoshino Y, et al. Analysis of anterior tibial subluxation to the femur at maximum extension in anterior cruciate ligament-deficient knees. J Orthop Surg Hong K. 2019:27(1).

10.

Mishima S, Takahashi S, Kondo S, Ishiguro N. Anterior tibial subluxation in anterior cruciate ligament-deficient knees: quantification using magnetic resonance imaging. Arthroscopy. 2005;21(10):1193–6.CrossRefPubMed

11.

Donell ST, Marshall TJ, Darrah C, Shepstone L. Cruciate ligament assessment in MRI scans: a pilot study of a static drawer technique. Knee. 2006;13(2):137–44.CrossRefPubMed

12.

Song GY, Zhang H, Zhang J, Liu X, Xue Z, Qian Y, et al. Greater static anterior tibial subluxation of the lateral compartment after an acute anterior cruciate ligament injury is associated with an increased posterior tibial slope. Am J Sports Med. 2018;46(7):1617–23.CrossRefPubMed

13.

Lian J, Novaretti JV, Sheean AJ, Patel NK, Whaley S, Popchak A, et al. Static lateral tibial plateau subluxation predicts high-grade rotatory knee laxity in anterior cruciate ligament-deficient knees. Am J Sports Med. 2019;47(2):277–84.CrossRefPubMed

14.

Zheng T, Song GY, Feng H, Zhang H, Li Y, Li X, et al. Lateral meniscus posterior root lesion influences anterior tibial subluxation of the lateral compartment in extension after anterior cruciate ligament injury. Am J Sports Med. 2020;48(4):838–46.CrossRefPubMed

15.

Zhang ZY, Pan XY, Maimaitijiang P, Meng LY, He ZY, Zhao Q, et al. Anterior tibial subluxation measured under a modified protocol is positively correlated with posterior tibial slope: a comparative study of MRI measurement methods. Knee Surg Sports Traumatol Arthrosc. 2022;30(10):3350–60.CrossRefPubMed

16.

Sigonney G, Klouche S, Chevance V, Bauer T, Rousselin B, Judet O, et al. Risk factors for passive anterior tibial subluxation on MRI in complete ACL tear. Orthop Traumatol Surg Res. 2020;106(3):465–8.CrossRefPubMed

17.

Hudek R, Schmutz S, Regenfelder F, Fuchs B, Koch PP. Novel measurement technique of the tibial slope on conventional MRI. Clin Orthop Relat Res. 2009;467(8):2066–72.CrossRefPubMedPubMedCentral

18.

Jayasekara DN, Sooriyarachchi MR. A simulation based study for comparing tests associated with receiver operating characteristic (ROC) curves. Commun Stat Simul C. 2014;43(10):2444–67.CrossRef

19.

Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–63.CrossRefPubMedPubMedCentral

20.

Klass D, Toms AP, Greenwood R, Hopgood P. MR imaging of acute anterior cruciate ligament injuries. Knee. 2007;14(5):339–47.CrossRefPubMed

21.

Amis AA. The functions of the fibre bundles of the anterior cruciate ligament in anterior drawer, rotational laxity and the pivot shift. Knee Surg Sports Traumatol Arthrosc. 2012;20(4):613–20.CrossRefPubMed

Titel: Comparisons of diagnostic performance and the reliability in identifying ACL injury between two measuring protocols of anterior tibial subluxation on MR images
verfasst von: Zhi-yu Zhang
Hong-jie Huang
Pakezhati Maimaitijiang
Xiao-yu Pan
Xiao-yue Fu
Cheng Wang
Jian-quan Wang
Publikationsdatum: 10.04.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Skeletal Radiology / Ausgabe 9/2023
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-023-04336-1

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Comparisons of diagnostic performance and the reliability in identifying ACL injury between two measuring protocols of anterior tibial subluxation on MR images