Objective To construct a nomogram model of anterior cruciate ligament avulsion fracture at tibial insertion based on MRI-related parameters. Methods A retrospective study was conducted on 143 patients with anterior knee pain who were treated in the Department of Orthopaedics of Jiangxi Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2019 to December 2022. According to the results of imaging examination, the patients were divided into an observation group (anterior cruciate ligament avulsion fracture at tibial insertion) and a control group (other knee injury patients or healthy adults). Multivariate logistic regression analysis was used to analyze the influencing factors of tibial avulsion fracture of cruciate ligament and to construct a nomogram prediction model for the risk of anterior cruciate ligament avulsion fracture at tibial insertion. The accuracy of the model was judged by ROC curve. Another 70 patients with anterior knee pain who met the inclusion criteria in the hospital from January to August 2023 were used for success rate prediction, the actual observed results were compared, and the fitting degree of the model was evaluated by Hosmer-Lemeshow test. Results Among the 143 cases, 80 cases (55.94%) were in the observation group and 63 cases (44.06%) were in the control group. The Multivariate analysis showed that the medial tibial plateau posterior inclination angle [MTS, OR=1.733, 95% CI (1.346,2.232)], lateral tibial plateau posterior inclination angle [LTS, OR=1.907, 95% CI (1.346,-2.741)] and medial tibial plateau depth [MTD; OR=0.059, 95% CI (0.019,0.188)] were independent influencing factors for the occurrence of anterior cruciate ligament avulsion fracture at tibial insertion (P<0.05). On this basis, a risk prediction model was established, whose model formula was Logit (p)=1.831+0.550×MTS+0.645×LTS-2.824×MTD. The area under the ROC curve was 0.901, 95% CI (0.849,0.952), the sensitivity was 82.50%, the specificity was 88.90%, and the Youden index was 0.714. The total prediction accuracy of the external validation model was 85.20%, and the Hosemer-Lemeshow test showed χ2=10.111, P=0.257. Conclusions The Nomogram model of anterior cruciate ligament avulsion fracture at tibial insertion based on MRIp-related parameters has good predictive efficacy, and the MTS, LTS and MTD values can be used as indicators for predicting the risk of the disease.
Key words
MRI /
anterior cruciate ligament avulsion fracture at tibial insertion /
nomogram /
prediction model /
tibial plateau anatomical parameters /
knee joint biomechanics
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