Background:

Although several factors are associated with anterior cruciate ligament (ACL) rerupture, the effect of anatomic factors associated with ACL rupture on ACL rerupture development has not been evaluated.

Purpose:

To determine individual anatomic parameters independently associated with ACL rerupture and the diagnostic values of these parameters.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 91 male patients with ACL rerupture and 182 age-, sex-, body mass index–, and side dominance–matched patients without rerupture who underwent ACL reconstruction with a 5-year follow-up were included. In all, 35 parameters that were previously defined as risk factors for primary ACL rupture were compared between the 2 groups. Uni- and multivariate logistic regression models were created to evaluate independently associated factors. Receiver operating characteristic curve analysis was performed for independently associated parameters to predict sensitivity, specificity, and cutoff values.

Results:

The mean ± standard deviation age of patients at the time of index surgery was 26.5 ± 6.7 years. Notch shape index (P = .014), tibial proximal anteroposterior (AP) distance (TPAPD) (P < .001), lateral femoral condylar AP distance (LCAPD)/TPAPD ratio (P < .001), medial meniscal cartilage bone height (P < .001), and lateral meniscal bone angle (P = .004) were found to be significantly different between the 2 groups. Only the LCAPD/TPAPD ratio (odds ratio, 2.713; 95% CI, 1.998-5.480; P < .001) was found to be independently associated with ACL rerupture development. The LCAPD/TPAPD ratio revealed 78.9% sensitivity and 75.5% specificity (area under the curve, 0.815; 95% CI, 0.760-0.870) for values above 1.52.

Conclusion:

The LCAPD/TPAPD ratio can be used to distinguish patients who are at risk of developing ACL rerupture from patients who are not. In the clinical practice, findings of this study may help to develop surgical and nonsurgical preventive strategies in ACL rerupture development.

中文翻译：

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与男性前交叉韧带断裂相关的解剖学因素：病例对照研究

背景：

尽管有几个因素与前交叉韧带 (ACL) 再断裂有关，但与 ACL 断裂相关的解剖学因素对 ACL 再断裂发展的影响尚未得到评估。

目的：

确定与 ACL 再破裂独立相关的个体解剖参数以及这些参数的诊断价值。

学习规划：

病例对照研究；证据水平，3。

方法：

共纳入 91 名 ACL 再破裂的男性患者和 182 名年龄、性别、体重指数和侧优势匹配的无再破裂患者，他们接受了 ACL 重建，并进行了 5 年的随访。总之，在两组之间比较了以前定义为原发性 ACL 破裂危险因素的 35 个参数。创建单变量和多变量逻辑回归模型以评估独立相关因素。对独立相关的参数进行接受者操作特征曲线分析，以预测敏感性、特异性和临界值。

结果：

首次手术时患者的平均±标准差年龄为 26.5±6.7 岁。缺口形状指数 ( P = .014)、胫骨近端前后 (AP) 距离 (TPAPD) ( P < .001)、股骨外侧髁 AP 距离 (LCAPD)/TPAPD 比值 ( P < .001)、内侧半月板软骨骨高度( P < .001) 和外侧半月板骨角 ( P = .004) 在两组之间有显着差异。只有 LCAPD/TPAPD 比率（优势比，2.713；95% CI，1.998-5.480；P< .001) 被发现与 ACL 再破裂的发展独立相关。对于高于 1.52 的值，LCAPD/TPAPD 比率显示 78.9% 的敏感性和 75.5% 的特异性（曲线下面积，0.815；95% CI，0.760-0.870）。

结论：

LCAPD/TPAPD 比率可用于区分有 ACL 再破裂风险的患者和没有风险的患者。在临床实践中，本研究的结果可能有助于制定 ACL 再破裂发展的手术和非手术预防策略。