Department of Orthopaedic Surgery, Centre Hospitalier, Clinique d'Eich, 76, Rue D'Eich, 1460, Luxembourg, Luxembourg.
Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12):2072-5. doi: 10.1007/s00167-011-1550-9. Epub 2011 May 24.
The goal of the present report was to describe a new clinical sign to make a clinical diagnosis of meniscal extrusion related to medial meniscal root avulsion.
Description of an easy clinical sign to detect extrusion of the medial meniscus at the anteromedial joint line. A varus stress test was applied in full extension before and after transosseous repair of an isolated traumatic avulsion of the posterior root of the medial meniscus in a 21-year-old patient. The clinical sign was verified by sectioning of the meniscotibial ligament during knee arthroplasty surgery in 3 patients.
With a deficient posterior root, the clinical sign was positive, showing anteromedial extrusion under varus stress. After repair and at clinical follow-up, extrusion was normalized.
Making the clinical diagnosis of medial meniscus extrusion after knee injury by applying a simple varus stress test to the knee and palpating the anteromedial meniscal extrusion might help physicians to suspect a medial meniscus root tear in the early stages after the injury as well as to evaluate its reduction after repair. A varus stress test in full extension should be performed systematically in patients where a root tear of the medial meniscus is suspected as well as after surgery to evaluate the success of the repair.
本报告的目的是描述一种新的临床征象,以便对与内侧半月板后根部撕裂相关的半月板外突做出临床诊断。
描述一种易于在关节线前内侧检测到内侧半月板外突的临床征象。在 21 岁患者单独的内侧半月板后根部外伤性撕脱伤行经皮骨道修复后,先在完全伸直位,后在轻度内翻位对膝关节施加侧方应力。在 3 例膝关节置换术中切断半月板胫骨韧带,验证该临床征象。
后根部撕裂时,该临床征象阳性,表现为轻度内翻时前内侧半月板外突。修复后及临床随访时,外突恢复正常。
膝关节损伤后,通过对膝关节施加简单的内翻侧方应力并触诊前内侧半月板外突,可做出内侧半月板外突的临床诊断。这有助于医生在损伤后早期怀疑内侧半月板根部撕裂,并评估其修复后的复位情况。怀疑内侧半月板根部撕裂时,或术后应系统地在完全伸直位行内翻侧方应力试验,以评估修复的效果。