Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, Seoul, Korea.
Knee Surg Sports Traumatol Arthrosc. 2011 Feb;19(2):222-9. doi: 10.1007/s00167-010-1274-2. Epub 2010 Oct 2.
the purpose of this study was to determine the effect of a radial tear on degenerative medial meniscus posterior horn tear extrusion and to identify predictors of medial meniscus extrusion.
we reviewed the records of 102 knees with medial meniscus posterior horn tears and degeneration that underwent a partial meniscectomy. Tears were classified as root (n = 17) and non-root (n = 85) tears, or as radial (n = 46) and non-radial (n = 56) tears. Groups were compared in terms of absolute and relative meniscal extrusion, and the proportion of knees with major (> 3 mm) extrusion. Multiple regression analysis was used to identify predictors of extrusion.
the radial group had greater mean absolute (4 ± 1 vs. 3 ± 1 mm, P = 0.001) and relative (31 ± 11 vs. 23 ± 12%, P = 0.031) extrusion than the non-radial group. The radial group also had a greater proportion of major extrusions than the non-radial group (74% vs. 26%; P = 0.016). In contrast, the root tear and non-root tear groups were similar in terms of mean absolute (3 ± 1 vs. 3 ± 1 mm, P = n.s.) and relative (30 ± 7 vs. 26 ± 13%; P = n.s.) extrusion and in terms of proportion with major extrusions (59 vs. 55%; P = n.s.). Extrusion was found to be associated with a similar strength with both the presence of a radial component and the preoperative Kellgren-Lawrence grade.
meniscal extrusion was greater and more severe in knees with a radial tear component than in knees without a radial component. The incidence and degree of major extrusion was similar in knees with root tears and non-root tears. A radial component and knee osteoarthritis severity were similarly predictive of absolute and relative extrusion. Meniscal extrusion in osteoarthritic knees was associated not only with degenerative meniscal tear but also with osteoarthritis severity. Therefore, arthroscopic meniscal procedures, especially meniscal repair, should be cautiously considered in patients with meniscal extrusion.
本研究旨在确定放射状撕裂对退行性半月板后角撕裂突出的影响，并确定半月板突出的预测因素。
我们回顾了 102 例内侧半月板后角撕裂伴退变行部分半月板切除术患者的病历。将撕裂分为根（n = 17）和非根（n = 85）撕裂，或放射状（n = 46）和非放射状（n = 56）撕裂。比较两组绝对和相对半月板突出程度，以及有明显（> 3mm）突出的膝关节比例。采用多元回归分析确定突出的预测因素。
放射状组的平均绝对（4 ± 1 比 3 ± 1mm，P = 0.001）和相对（31 ± 11 比 23 ± 12%，P = 0.031）突出均大于非放射状组。放射状组明显有更大比例的明显突出（74%比 26%；P = 0.016）。相比之下，根撕裂和非根撕裂组在绝对（3 ± 1 比 3 ± 1mm，P = n.s.）和相对（30 ± 7 比 26 ± 13%；P = n.s.）突出程度以及有明显突出的比例（59 比 55%；P = n.s.）上无显著差异。研究发现，放射状撕裂与存在放射状撕裂成分和术前 Kellgren-Lawrence 分级具有相似的关联强度。
放射状撕裂组的半月板突出程度和严重程度均大于无放射状撕裂组。根撕裂和非根撕裂组的明显突出发生率和程度相似。放射状撕裂成分和膝关节骨关节炎严重程度同样可以预测绝对和相对突出。膝关节骨关节炎中的半月板突出不仅与退行性半月板撕裂有关，还与骨关节炎严重程度有关。因此，对于有半月板突出的患者，应谨慎考虑关节镜下半月板手术，尤其是半月板修复。
