urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.2.76OAURFYurmj-1498Research ArticleОригинальные статьи | Original articlesOriginal articlesВариативная анатомия коленного сустава и влияние отдельных ее параметров на топографию передней крестообразной связкиVariability of Knee Joint Anatomy and the Impact of Its Individual Parameters on the Topography of the Anterior Cruciate Ligamenthttps://orcid.org/0000-0002-8037-1674ВолодинИ. В.VolodinI. V.

Илья Владимирович Володин — ассистент кафедры травматологии, ортопедии и ВПХ, Волгоградский государственный медицинский университет; младший научный сотрудник лаборатории клинической и экспериментальной ортопедии, Волгоградский медицинский научный центр

Волгоград

Ilia V. Volodin — Assistant of the Department of Traumatology, Orthopedics and Military Field Surgery, Volgograd State Medical University; Junior Researcher of the Laboratory of Clinical and Experimental Orthopedics, Volgograd Science Medical Center

Volgograd

volodin_ili@mail.ruhttps://orcid.org/0000-0001-7507-0570МаланинД. А.MalaninD. A.

Дмитрий Александрович Маланин — доктор медицинских наук, профессор, заведующий кафедрой травматологии, ортопедии и ВПХ, Волгоградский государственный медицинский университет; заведующий лабораторией клинической и экспериментальной ортопедии, Волгоградский медицинский научный центр

Волгоград

Dmitry A. Malanin — Doctor of Sciences (Medicine), Professor, Head of the Department of Traumatology, Orthopedics and Military Field Surgery, Volgograd State Medical University; Head of the Laboratory of Clinical and Experimental Orthopedics, Volgograd Science Medical Center

Volgograd

malanin67@mail.ruhttps://orcid.org/0000-0002-0079-853XКалитинК. Ю.KalitinK. Y.

Константин Юрьевич Калитин — кандидат медицинских наук, доцент, доцент кафедры фармакологии и биоинформатики, Волгоградский государственный медицинский университет; научный сотрудник лаборатории экспериментальной фармакологии, Волгоградский медицинский научный центр

Волгоград

Konstantin Y. Kalitin — Candidate of Sciences (Medicine), Associate Professor, Associate Professor of the Department of Pharmacology and Bioinformatics, Volgograd State Medical University; Researcher of the Laboratory of Experimental Pharmacology, Volgograd Science Medical Center

Volgograd

kkonst8@ya.ruhttps://orcid.org/0000-0002-0429-905XМухаО. Ю.MukhaO. Y.

Ольга Юрьевна Муха — лаборант кафедры фармакологии и биоинформатики

Волгоград

Olga Y. Mukha — Laboratory Technician of the Department of Pharmacology and Bioinformatics

Volgograd

olay.myha14@gmail.comhttps://orcid.org/0000-0001-7375-5365СучилинИ. А.SuchilinI. A.

Илья Алексеевич Сучилин — кандидат медицинских наук, доцент кафедры травматологии, ортопедии и ВПХ, Волгоградский государственный медицинский университет; научный сотрудник лаборатории экспериментальной фармакологии, Волгоградский медицинский научный центр

Волгоград

Ilia A. Suchilin — Candidate of Sciences (Medicine), Associate Professor of the Department Traumatology, Orthopedics and Military Field Surgery, Volgograd State Medical University; Researcher of the Laboratory of Clinical and Experimental Orthopedics, Volgograd Science Medical Center

Volgograd

omnio@mail.ruЧерезовЛ. Л.CherezovL. L.

Леонид Леонидович Черезов — кандидат медицинских наук, доцент кафедры травматологии, ортопедии и ВПХ

Волгоград

Leonid L. Cherezov — Candidate of Sciences (Medicine), Associate Professor of the Department of Traumatology, Orthopedics and Military Field Surgery

Volgograd

lchrzv@rambler.ruВолгоградский государственный медицинский университет; Волгоградский медицинский научный центрРоссияVolgograd State Medical University; Volgograd Science Medical CenterRussian FederationВолгоградский государственный медицинский университетРоссияVolgograd State Medical UniversityRussian Federation2024100520242327688Copyright © Володин И.В., Маланин Д.А., Калитин К.Ю., Муха О.Ю., Сучилин И.А., Черезов Л.Л., 20242024Володин И.В., Маланин Д.А., Калитин К.Ю., Муха О.Ю., Сучилин И.А., Черезов Л.Л.Volodin I.V., Malanin D.A., Kalitin K.Y., Mukha O.Y., Suchilin I.A., Cherezov L.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1498Введение

Введение. Анатомические особенности строения коленного сустава имеют значение как потенциальные предикторы различных заболеваний и травм. Однако взаимосвязь между анатомическим расположением передней крестообразной связки и параметрами строения сустава до сих пор остается недостаточно изученной. Наша работа направлена на выявление статистически значимых взаимосвязей между отдельными параметрами коленного сустава и их зависимость с топографией передней крестообразной связки.

Цель работы — определить статистически значимые взаимосвязи между отдельными параметрами сустава и их потенциальное влияние на расположение передней крестообразной связки в суставе по данным магнитно-резонансной томографии.

Материалы и методы

Материалы и методы. В ходе исследования были проанализированы МРТ-изображения 391 КС у пациентов разного пола. Проведены измерения по 19 параметрам с использованием стандартных инструментов линейных и угловых измерений. Полученные данные подверглись статистической обработке.

Результаты

Результаты. Анатомическое строение коленного сустава и областей прикрепления передней крестообразной связки демонстрируют не только гендерные и расовые особенности, но и индивидуальные черты конкретного сустава. Выявлено шесть факторов, оказывающих влияние на расположение связки.

Обсуждение

Обсуждение. Результаты исследования выявили несостоятельность существующих классификаций строения коленного сустава, подчеркивая необходимость поиска взаимосвязей между параметрами сустава. Факторный анализ измеренных значений позволяет выделить новые системы взаимосвязанных параметров, которые могут не зависеть от пола пациента. Исследование подчеркивает важность разработки новых методов анализа МРТ коленного сустава с использованием многопараметрических моделей.

Заключение

Заключение. Наше исследование выделяет важные взаимосвязи между параметрами коленного сустава и расположением передней крестообразной связки. Факторы, влияющие на эту динамику, подчеркивают необходимость индивидуализированного подхода к планированию пластики связки. Результаты предоставляют основу для разработки более точных методов анализа и персонализированных стратегий лечения ортопедических заболеваний, повышая эффективность клинической практики.

Introduction

Introduction. The anatomical features of the knee joint are significant as potential predictors of various diseases and injuries. However, the relationship between the anatomical position of the ACL and the structural parameters of the knee remains insufficiently studied. This work aims to identify statistically significant correlations between individual knee parameters and their association with the topography of the ACL within the joint.

Purpose of the study

Purpose of the study. To determine statistically significant relationships between individual knee parameters and their potential impact on the positioning of the ACLin the joint based on MRI data.

Materials and methods

Materials and methods. The study involved the analysis of MRI images of 391 knee from patients of different sexes. Measurements were taken for 19 parameters using standard tools for linear and angular measurements. The data underwent statistical processing.

Results and discussion

Results and discussion. Six factors influencing the positioning of the ACL were identified. The study results challenge the validity of existing knee structure classifications, highlighting the need to explore the relationships between joint parameters. Factor analysis of the measured knee values allows for the identification of new systems of interrelated parameters, including those independent of patient sex. The study emphasizes the importance of developing new MRI analysis methods for the knee using multiparametric models.

Conclusion

Conclusion. Our research highlights important correlations between knee parameters and the positioning of the ACL. Factors affecting this dynamic underscore the need for an individualized approach to planning ACL reconstruction. The results provide a basis for developing more accurate analysis methods and personalized treatment strategies for orthopedic diseases, enhancing the efficacy of clinical practice.

пластика ПКСморфометрия коленного суставаМРТ коленного суставаACL reconstructionknee joint morphometryknee MRIReferencesHasoon J, Al-Dadah O. Knee anatomic geometry accurately predicts risk of anterior cruciate ligament rupture. Acta Radiologica. 2023;64(5):1904–1911. DOI: https://doi.org/10.1177/02841851231152329.Hasoon J, Al-Dadah O. Knee anatomic geometry accurately predicts risk of anterior cruciate ligament rupture. Acta Radiologica. 2023;64(5):1904–1911. DOI: https://doi.org/10.1177/02841851231152329.Schneider A, Si-Mohamed S, Magnussen RA, Lustig S, Neyret P, Servien E. Tibiofemoral joint congruence is lower in females with ACL injuries than males with ACL injuries. Knee Surgery, Sports Traumatology, Arthroscopy. 2018;26:1375–1383. DOI: https://doi.org/10.1007/s00167-017-4756-7.Schneider A, Si-Mohamed S, Magnussen RA, Lustig S, Neyret P, Servien E. Tibiofemoral joint congruence is lower in females with ACL injuries than males with ACL injuries. Knee Surgery, Sports Traumatology, Arthroscopy. 2018;26:1375–1383. DOI: https://doi.org/10.1007/s00167-017-4756-7.Levins JG, Sturnick DR, Argentieri EC, Gardner-Morse M, Vacek PM, Desarno MJ, et al. Geometric risk factors associated with noncontact anterior cruciate ligament graſt rupture. The American Journal of Sports Medicine. 2016;44(10):2537–2545. DOI: https://doi.org/10.1177/0363546516657525.Levins JG, Sturnick DR, Argentieri EC, Gardner-Morse M, Vacek PM, Desarno MJ, et al. Geometric risk factors associated with noncontact anterior cruciate ligament graſt rupture. The American Journal of Sports Medicine. 2016;44(10):2537–2545. DOI: https://doi.org/10.1177/0363546516657525.Beaulieu ML, Nowak EK, Beynnon BD, Ashton-Miller JA, Sturnick DR, Wojtys EM. Clinical-grade MRI-based methods to identify combined anatomic factors that predict ACL injury risk in male and female athletes. The American Journal of Sports Medicine. 2021;49(10):2615–2623. DOI: https://doi.org/10.1177/03635465211024249.Beaulieu ML, Nowak EK, Beynnon BD, Ashton-Miller JA, Sturnick DR, Wojtys EM. Clinical-grade MRI-based methods to identify combined anatomic factors that predict ACL injury risk in male and female athletes. The American Journal of Sports Medicine. 2021;49(10):2615–2623. DOI: https://doi.org/10.1177/03635465211024249.Malanin DA, VolodinIV, SuchilinIA, Demeschenko MV. Gender differences of the ACL insertion sites. Traumatology and Orthopaedics in Russia. 2020;26(4):80–92. (In Russ.). DOI: https://doi.org/10.21823/2311-2905-2020-26-4-80-92.Malanin DA, VolodinIV, SuchilinIA, Demeschenko MV. Gender differences of the ACL insertion sites. Traumatology and Orthopaedics in Russia. 2020;26(4):80–92. (In Russ.). DOI: https://doi.org/10.21823/2311-2905-2020-26-4-80-92.Li M, Ji G, Fan L, Fan CY, Lin W, Yang GM, et al. Assessment of patellar morphology in trochlear dysplasia on computed tomography scans. Orthopaedic Surgery. 2021;13(2):458–465. DOI: https://doi.org/10.1111/os.12825.Li M, Ji G, Fan L, Fan CY, Lin W, Yang GM, et al. Assessment of patellar morphology in trochlear dysplasia on computed tomography scans. Orthopaedic Surgery. 2021;13(2):458–465. DOI: https://doi.org/10.1111/os.12825.Ellison TM, Flagstaff I, Johnson AE. Sexual dimorphisms in anterior cruciate ligament injury: A current concepts review. Orthopaedic Journal of Sports Medicine. 2021;9(12):23259671211025304. DOI: https://doi.org/10.1177/23259671211025304.Ellison TM, Flagstaff I, Johnson AE. Sexual dimorphisms in anterior cruciate ligament injury: A current concepts review. Orthopaedic Journal of Sports Medicine. 2021;9(12):23259671211025304. DOI: https://doi.org/10.1177/23259671211025304.Patel AP, Gronbeck C, Chambers M, Harrington MA, Halawi MJ. Gender and total joint arthroplasty: Variable outcomes by procedure type. Arthroplasty Today. 2020;6(3):517–520. DOI: https://doi.org/10.1016/j.artd.2020.06.012.Patel AP, Gronbeck C, Chambers M, Harrington MA, Halawi MJ. Gender and total joint arthroplasty: Variable outcomes by procedure type. Arthroplasty Today. 2020;6(3):517–520. DOI: https://doi.org/10.1016/j.artd.2020.06.012.Asseln M, Hänisch C, Schick F, Radermacher К. Gender differencesin knee morphology and the prospects for implant design in total knee replacement. The Knee. 2018;25(4):545–558. DOI: https://doi.org/10.1016/j.knee.2018.04.005.Asseln M, Hänisch C, Schick F, Radermacher К. Gender differencesin knee morphology and the prospects for implant design in total knee replacement. The Knee. 2018;25(4):545–558. DOI: https://doi.org/10.1016/j.knee.2018.04.005.Tan SH, Lau BP, Khin LW, Lingaraj K. The importance of patient sex in the outcomes of anterior cruciate ligament reconstructions: A systematic review and meta-analysis. The American Journal of Sports Medicine. 2016;44(1):242–254. DOI: https://doi.org/10.1177/0363546515573008.Tan SH, Lau BP, Khin LW, Lingaraj K. The importance of patient sex in the outcomes of anterior cruciate ligament reconstructions: A systematic review and meta-analysis. The American Journal of Sports Medicine. 2016;44(1):242–254. DOI: https://doi.org/10.1177/0363546515573008.Hirtler L, Kainberger F, Röhrich S. The intercondylar fossa — A narrative review. Clinical Anatomy. 2022;35(1):2–14. DOI: https://doi.org/10.1002/ca.23773.Hirtler L, Kainberger F, Röhrich S. The intercondylar fossa — A narrative review. Clinical Anatomy. 2022;35(1):2–14. DOI: https://doi.org/10.1002/ca.23773.Mahfouz M, Abdel Fatah EE, Bowers LS, Scuderi G. Three-dimensional morphology of the knee reveals ethnic differences. Clinical Orthopaedics and Related Research. 2012;470:172–185. DOI: https://doi.org/10.1007/s11999-011-2089-2.Mahfouz M, Abdel Fatah EE, Bowers LS, Scuderi G. Three-dimensional morphology of the knee reveals ethnic differences. Clinical Orthopaedics and Related Research. 2012;470:172–185. DOI: https://doi.org/10.1007/s11999-011-2089-2.Everhart JS, Chaudhari AM, Flanigan DC. Creation of a simple distal femur morphology classification system. Journal of Orthopaedic Research. 2016;34:924–931. DOI: https://doi.org/10.1002/jor.23102.Everhart JS, Chaudhari AM, Flanigan DC. Creation of a simple distal femur morphology classification system. Journal of Orthopaedic Research. 2016;34:924–931. DOI: https://doi.org/10.1002/jor.23102.Gillespie RJ, Levine A, Fitzgerald SJ, Kolaczko J, DeMaio M, Marcus RE, et al. Gender differencesin the anatomy of the distal femur. The Journal of Bone & Joint Surgery British Volume. 2011;93:357–363. DOI: https://doi.org/10.1302/0301-620X.93B3.24708.Gillespie RJ, Levine A, Fitzgerald SJ, Kolaczko J, DeMaio M, Marcus RE, et al. Gender differencesin the anatomy of the distal femur. The Journal of Bone & Joint Surgery British Volume. 2011;93:357–363. DOI: https://doi.org/10.1302/0301-620X.93B3.24708.Hanna A, Hollnagel K, Whitmer K, John C, Johnson B, Godin J, et al. Reliability of magnetic resonance imaging prediction of anterior cruciate ligament autograſt size and comparison of radiologist and orthopaedic surgeon predictions. Orthopaedic Journal of Sports Medicine. 2019;7(12):2325967119889593. DOI: https://doi.org/10.1177/2325967119889593.Hanna A, Hollnagel K, Whitmer K, John C, Johnson B, Godin J, et al. Reliability of magnetic resonance imaging prediction of anterior cruciate ligament autograſt size and comparison of radiologist and orthopaedic surgeon predictions. Orthopaedic Journal of Sports Medicine. 2019;7(12):2325967119889593. DOI: https://doi.org/10.1177/2325967119889593.Camarda L, Grassedonio E, Albano D, Galia M, Midiri M, D’Arienzo M. MRI evaluation to predict tendon size for knee ligament reconstruction. Muscles, Ligaments and Tendons Journal. 2018;7(3):478–484. DOI: https://doi.org/10.11138/mltj/2017.7.3.478.Camarda L, Grassedonio E, Albano D, Galia M, Midiri M, D’Arienzo M. MRI evaluation to predict tendon size for knee ligament reconstruction. Muscles, Ligaments and Tendons Journal. 2018;7(3):478–484. DOI: https://doi.org/10.11138/mltj/2017.7.3.478.Li K, Cavaignac E, Xu W, Cheng Q, Telmon N, Huang W. Morphometric evaluation of the knee in Chinese population reveals sexual dimorphism and age-related differences. International Orthopaedics. 2018;42(10):2349–2356. DOI: https://doi.org/10.1007/s00264-018-3826-x.Li K, Cavaignac E, Xu W, Cheng Q, Telmon N, Huang W. Morphometric evaluation of the knee in Chinese population reveals sexual dimorphism and age-related differences. International Orthopaedics. 2018;42(10):2349–2356. DOI: https://doi.org/10.1007/s00264-018-3826-x.Hasoon J, Al-Dadah O. Knee anatomic geometry accurately predicts risk of anterior cruciate ligament rupture. Acta Radiologica. 2023;64(5):1904–1911. DOI: https://doi.org/10.1177/02841851231152329.Hasoon J, Al-Dadah O. Knee anatomic geometry accurately predicts risk of anterior cruciate ligament rupture. Acta Radiologica. 2023;64(5):1904–1911. DOI: https://doi.org/10.1177/02841851231152329.Barnum MS, Boyd ED, Vacek P, Slauterbeck JR, Beynnon BD. Association of geometric characteristics of knee anatomy (alpha angle and intercondylar notch type) with noncontact ACL injury. The American Journal of Sports Medicine. 2021;49(10):2624–2630. DOI: https://doi.org/10.1177/03635465211023750.Barnum MS, Boyd ED, Vacek P, Slauterbeck JR, Beynnon BD. Association of geometric characteristics of knee anatomy (alpha angle and intercondylar notch type) with noncontact ACL injury. The American Journal of Sports Medicine. 2021;49(10):2624–2630. DOI: https://doi.org/10.1177/03635465211023750.Maijanen H, Junno JA, Keisu A, Niinimäki J, Lehenkari P, Oura P. Sex estimation from knee breadth dimensions in a Finnish population. Legal Medicine. 2021;51:101873. DOI: https://doi.org/10.1016/j.legalmed.2021.101873.Maijanen H, Junno JA, Keisu A, Niinimäki J, Lehenkari P, Oura P. Sex estimation from knee breadth dimensions in a Finnish population. Legal Medicine. 2021;51:101873. DOI: https://doi.org/10.1016/j.legalmed.2021.101873.Gültekin MZ, Dinçel YM, Keskin Z, Arslan S, Yıldırım A. Morphometric risk factors effects on anterior cruciate ligament injury. Joint Diseases and Related Surgery. 2023;34(1):130–137. DOI: https://doi.org/10.52312/jdrs.2023.910.Gültekin MZ, Dinçel YM, Keskin Z, Arslan S, Yıldırım A. Morphometric risk factors effects on anterior cruciate ligament injury. Joint Diseases and Related Surgery. 2023;34(1):130–137. DOI: https://doi.org/10.52312/jdrs.2023.910.Lansdown D, Ma CB. The influence of tibial and femoral bone morphology on knee kinematicsin the anterior cruciate ligament injured knee. Clinics in Sports Medicine. 2018;37(1):127–136. DOI: https://doi.org/10.1016/j.csm.2017.07.012.Lansdown D, Ma CB. The influence of tibial and femoral bone morphology on knee kinematicsin the anterior cruciate ligament injured knee. Clinics in Sports Medicine. 2018;37(1):127–136. DOI: https://doi.org/10.1016/j.csm.2017.07.012.Shen L, Jin ZG, Dong QR, Li LB. Anatomical risk factors of anterior cruciate ligament injury. Chinese Medical Journal. 2018;131 (24):2960–2967. DOI: https://doi.org/10.4103/0366-6999.247207.Shen L, Jin ZG, Dong QR, Li LB. Anatomical risk factors of anterior cruciate ligament injury. Chinese Medical Journal. 2018;131 (24):2960–2967. DOI: https://doi.org/10.4103/0366-6999.247207.Dimitriou D, Wang Z, Zou D, Helmy N, Tsai TY. Do sex-specific differences exist in ACL attachment location? An MRI-based 3-dimensional topographic analysis. Orthopaedic Journal of Sports Medicine. 2020;8(11):2325967120964477. DOI: https://doi.org/10.1177/2325967120964477.Dimitriou D, Wang Z, Zou D, Helmy N, Tsai TY. Do sex-specific differences exist in ACL attachment location? An MRI-based 3-dimensional topographic analysis. Orthopaedic Journal of Sports Medicine. 2020;8(11):2325967120964477. DOI: https://doi.org/10.1177/2325967120964477.Hosseinzadeh S, Kiapour AM. Sex differencesin anatomic features linked to anterior cruciate ligament injuries during skeletal growth and maturation. The American Journal of Sports Medicine. 2020;48(9):2205–2212. DOI: https://doi.org/10.1177/0363546520931831.Hosseinzadeh S, Kiapour AM. Sex differencesin anatomic features linked to anterior cruciate ligament injuries during skeletal growth and maturation. The American Journal of Sports Medicine. 2020;48(9):2205–2212. DOI: https://doi.org/10.1177/0363546520931831.Devana SK, Solorzano C, Nwachukwu B, Jones KJ. Disparities in ACL reconstruction: the Influence of gender and race on incidence, treatment, and outcomes. Current Reviews in Musculoskeletal Medicine. 2022;15(1): 1–9. DOI: https://doi.org/10.1007/s12178–021–09736–1.Devana SK, Solorzano C, Nwachukwu B, Jones KJ. Disparities in ACL reconstruction: the Influence of gender and race on incidence, treatment, and outcomes. Current Reviews in Musculoskeletal Medicine. 2022;15(1): 1–9. DOI: https://doi.org/10.1007/s12178–021–09736–1.

The authors declare that there are no conflicts of interest present.