Yakup ALPAY, Atakan EZİCİ, Murat ÖNDER, Abdulhamit MISIR, Canan GÖNEN AYDIN, Avni İlhan BAYHAN

ÖN ÇAPRAZ BAĞ YARALANMASI İÇİN BİR RİSK FAKTÖRÜ OLARAK TİBİAL TÜBERKÜL - TROKLEAR OLUK MESAFESİNİN VE PATELLAR YÜKSEKLİĞİN DEĞERLENDİRİLMESİ

AMAÇ: Bu çalışmada Ön çapraz bağ ( ÖÇB)'ı sağlam ve ÖÇB'si kopuk olan hastalar arasındaki patellar yükseklik ve tibial tüberkül troklear oluk mesafesi (TT-TGd) arasındaki farkların değerlendirilmesi amaçlanmıştır.GEREÇ VE YÖNTEM: 18-40 yaşları arasında toplam 2019 hasta (1015 ÖÇB kopuk ve 1004 ÖÇB sağlam) çalışmaya dahil edildi. Patellar yükseklik ölçümünü belirlemek için Insall Salvati indeksi (ISI) kullanıldı. TT-TGd, aksiyel manyetik rezonans görüntüleri ile ölçüldü. İki ortopedi cerrahı, gözlemci içi ve gözlemciler arası güvenilirliği değerlendirmek için bağımsız olarak iki hafta ara ile 50 hastanın görüntüsünü inceledi. Ortalama patellar yükseklik ve TT-TGd ölçümleri ÖÇB'si kopuk olan hasta grubu ve sağlam ÖÇB'si olan kontrol grubu ile karşılaştırıldı.BULGULAR: Gözlemci içi ve gözlemciler arası uyum her iki ölçüm için de mükemmeldi (tüm ölçümler için p=0.001 ve k> 0.850). Patellar yükseklik ve TT-TGd, ÖÇB kopuk olan hastalarda kontrol grubuna göre anlamlı olarak daha yüksekti (sırasıyla 1.09 ± 0.37 ile 1.06 ± 0.56, p<0.001, 10.0 ± 3.3'e karşı 8.5 ± 3.0, p<0.001). ISI kadınlarda erkeklere göre anlamlı olarak daha yüksekti (1.13'e karşı 1.07, p<0.001). TT-TGd açısından cinsiyetler arasında anlamlı fark yoktu (9.5'e 9.3, p=0.792).SONUÇ: ÖÇB'si kopuk olan hastalarda patella yüksekliği ve TT-TGd anlamlı olarak artmış olmasına rağmen, bu farklılıklar normal aralıkta oldukları için klinik olarak önemli değildir.

Anahtar Kelimeler:

Ön çapraz bağ yaralanması, Patella yüksekliği, Risk faktör

EVALUATION OF THE TIBIAL TUBERCLE - TROCHLEAR GROOVE DISTANCE AND PATELLAR HEIGHT AS A RISK FACTOR FOR ANTERIOR CRUCIATE LIGAMENT INJURY

OBJECTIVE: This study aimed to evaluate the differences in patellar height and tibial tubercle- trochlear groove distance (TT-TGd) between patients with an intact anterior cruciate ligament (ACL) and ruptured ACL.MATERIAL AND METHODS: A total of 2019 patients (1015 with ruptured ACL and 1004 with an intact ACL) aged between 18-40 years were included. The Insall Salvati index (ISI) was used to determine the patellar height measurement. The TT-TGd was measured based on axial magnetic resonance images. Two orthopedic surgeons independently studied 50 patients’ images for two weeks to assess intra-observer and inter-observer reliability. The mean patellar height and TT-TGd measurements were compared between patients with ruptured ACL and those with an intact ACL.RESULTS: Interobserver and intraobserver agreement were excellent for both measurements (p = 0.001 and k> 0.850 for all measurements). Patellar height and TT-TGd were significantly higher in ACL ruptured patients than in the control group (1.09± 0.37 vs. 1.06± 0.56, p<0.001, 10.0± 3.3 vs. 8.5± 3.0, p<0.001, respectively). The ISI was significantly higher in women than in men (1.13 vs. 1.07, p<0.001). There was no significant difference between the sexes regarding the TT-TGd (9.5 vs. 9.3, p=0.792).CONCLUSIONS: Although significantly increased in patellar height and TT–TGd was detected in patients with ruptured ACL, these differences are not clinically important because they are in the normal range.

Keywords:

Anterior Cruciat Ligment injury, Patellar height, Risk factor,

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