自体半腱肌重建距腓前韧带后踝穴冠状角变化及距骨骨软骨损伤的预测

doi:10.13418/j.issn.1001-165x.2026.5.14

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中国临床解剖学杂志 ›› 2026, Vol. 44 ›› Issue (5) : 597-606. DOI: 10.13418/j.issn.1001-165x.2026.5.14

临床研究

自体半腱肌重建距腓前韧带后踝穴冠状角变化及距骨骨软骨损伤的预测

张万喜¹，宋忱²，韩彪³，邢捷⁴，王辉⁵*

作者信息 +

Changes in the coronal plane angle of the ankle mortise and prediction of talus osteochondral lesions after autologous semitendinosus tendon reconstruction of the anterior talofibular ligament

Zhang Wanxi ¹, Song Chen², Han Biao³, Xing Jie⁴, Wang Hui ⁵*

Author information +

文章历史 +

摘要

目的探讨踝关节外侧不稳患者自体半腱肌重建距腓前韧带（ATFL）治疗前后踝穴冠状位角度变化及其对术后距骨骨软骨损伤（OLT）的预测价值。方法选取2022年6月至2024年6月于本院治疗患者124例。采用重复测量方差分析、多元线性回归、LASSO回归、多因素Logistic回归、局部加权回归散点平滑法（LOWESS）及受试者工作特征（ROC）曲线分析踝穴冠状位、矢状位角度与关节稳定性的变化及对术后并发距骨骨软骨损伤的预测价值。结果并发OLT组患者治疗前后冠状位及矢状位角度、被动位置觉更高，其他关节稳定性指标更低，且均存在时间、组间及交互效应（P<0.001）。踝穴冠状位、矢状位角度与关节稳定性指标均呈独立相关（P<0.05）；治疗后1月冠状位角度为并发OLT危险因素，单独及联合矢状位角度预测OLT的AUC为0.879、0.937。结论冠状位角度是关节外侧不稳患者术后并发OLT的影响因素，对术后OLT有一定预测价值。

Abstract

Objective To investigate the changes of coronal angle of the ankle mortise before and after autologous semitendinosus tendon reconstruction of the anterior talofibular ligament (ATFL) in patients with lateral ankle instability and its predictive value for postoperative osteochondral lesion of the talus (OLT). Methods A total of 124 patients treated in our hospital from June 2022 to June 2024 were selected. Repeated measures analysis of variance, multiple linear regression, LASSO regression, multivariate Logistic regression, locally weighted scatterplot smoothing (LOWESS) and receiver operating characteristic (ROC) curve were used to analyze the changes of coronal and sagittal angles of the ankle mortise and joint stability, as well as their predictive value for postoperative OLT. Results Patients in the OLT complication group had higher coronal and sagittal angles and passive position sense, and lower other joint stability indicators before and after treatment, with significant time effect, inter-group effect and interaction effect (P<0.001). Both coronal and sagittal angles of the ankle mortise were independently correlated with joint stability indicators (P<0.05), the coronal angle at 1 month after treatment was a risk factor for OLT, and the AUC of the coronal angle alone and combined with the sagittal angle in predicting OLT was 0.879 and 0.937, respectively. Conclusions The coronal angle is an influencing factor for postoperative OLT in patients with lateral ankle instability, and has a certain predictive value for postoperative OLT.

导出引用

张万喜, 宋忱, 韩彪, 邢捷, 王辉. 自体半腱肌重建距腓前韧带后踝穴冠状角变化及距骨骨软骨损伤的预测[J]. 中国临床解剖学杂志. 2026, 44(5): 597-606 https://doi.org/10.13418/j.issn.1001-165x.2026.5.14

Zhang Wanxi, Song Chen, Han Biao, Xing Jie, Wang Hui. Changes in the coronal plane angle of the ankle mortise and prediction of talus osteochondral lesions after autologous semitendinosus tendon reconstruction of the anterior talofibular ligament[J]. Chinese Journal of Clinical Anatomy. 2026, 44(5): 597-606 https://doi.org/10.13418/j.issn.1001-165x.2026.5.14

中图分类号： R687.3 R322.72

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