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膝关节后内侧角:重新审视内侧损伤模式

The posteromedial corner of the knee: medial-sided injury patterns revisited.

作者信息

Sims William F, Jacobson Kurt E

机构信息

Hughston Clinic, Columbus, Georgia, USA.

出版信息

Am J Sports Med. 2004 Mar;32(2):337-45. doi: 10.1177/0363546503261738.

Abstract

BACKGROUND

Medial-sided knee injury patterns have been poorly defined in the available literature. The lack of definition can be attributed to the differing anatomic perspectives of physician authors and the functional significance they assigned to the posteromedial structures of the knee.

HYPOTHESIS

Many so-called medial collateral ligament injuries can involve significant damage to the posteromedial corner structures that may not be appreciated.

STUDY DESIGN

Retrospective cohort study.

METHOD

The authors reviewed the charts of 93 patients (93 knees) with operatively treated isolated and combined medial-sided knee injuries and described the associated medial injury patterns.

RESULTS

Ninety-nine percent of the knees were found to have an injury of the posterior oblique ligament. In the series, 70% of the knees also had an injury of the semimembranosus capsular attachment, and 30% were found to have complete peripheral detachment of the meniscus. Injury to the posterior oblique ligament was the common injury, but other sites of disruption capable of disabling this dynamic meniscocapsular complex were present.

CONCLUSIONS

Before assigning function to the various posteromedial structures of the knee, we must better define medial-sided injury patterns, the purpose of the current work. From this review of medial-sided injuries in this series of patients, the authors have come to realize that a subgroup of these knee injuries involves injuries to the posteromedial structures that are under-appreciated.

摘要

背景

在现有文献中,膝关节内侧损伤模式的定义尚不明确。定义不明确可归因于医生作者不同的解剖学观点以及他们赋予膝关节后内侧结构的功能意义。

假设

许多所谓的内侧副韧带损伤可能涉及后内侧角结构的严重损伤,而这些损伤可能未被重视。

研究设计

回顾性队列研究。

方法

作者回顾了93例(93个膝关节)接受手术治疗的孤立性和合并性膝关节内侧损伤患者的病历,并描述了相关的内侧损伤模式。

结果

发现99%的膝关节存在后斜韧带损伤。在该系列中,70%的膝关节还存在半膜肌囊附着处损伤,30%的膝关节半月板完全周边分离。后斜韧带损伤是常见损伤,但也存在其他能够破坏这种动态半月板-关节囊复合体的损伤部位。

结论

在赋予膝关节各种后内侧结构功能之前,我们必须更好地定义膝关节内侧损伤模式,这是当前工作的目的。通过对该系列患者膝关节内侧损伤的回顾,作者意识到这些膝关节损伤中的一个亚组涉及未被充分重视的后内侧结构损伤。

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