Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Ave, Pittsburgh, PA 15213, U.S.A.
Arthroscopy. 2012 Aug;28(8):1124-1134.e2. doi: 10.1016/j.arthro.2011.12.020. Epub 2012 Mar 21.
The purpose of this study was to examine the association of medial meniscus tear morphology with the pathogenesis of articular cartilage degeneration.
From May 2006 to December 2007, we prospectively evaluated 103 patients diagnosed with an isolated medial meniscus tear. Meniscus tear morphology and location, cartilage degeneration according to the Noyes score, and covariates including age, body mass index, gender, and injury date were documented. The relationship between severity of articular cartilage degeneration and meniscus tear morphology was analyzed by analysis of variance. Regression analysis was used to analyze predictors of severity of cartilage lesions.
Analysis of variance showed significant differences in the severity of articular cartilage lesions based on medial meniscus tear morphology (P < .05). Compared with bucket-handle/vertical tears, root and radial/flap tears were associated with significantly greater degeneration on the medial femoral condyle; root and complex tears were associated with significantly greater degeneration on the medial tibial plateau; and radial/flap tears were associated with significantly greater degeneration on the lateral tibial plateau. Age and gender were significant predictors of the Noyes medial-compartment score, and age, body mass index, and meniscus tear morphology were significant predictors of the Noyes lateral-compartment score.
Meniscus tears with increasing disruption of the circumferential meniscal fibers were significantly associated with cartilage lesions of increasing severity in both the medial and lateral compartments of the knee.
Level IV, prognostic case series.
本研究旨在探讨内侧半月板撕裂形态与关节软骨退变发病机制的关系。
2006 年 5 月至 2007 年 12 月，我们前瞻性评估了 103 例诊断为单纯内侧半月板撕裂的患者。记录半月板撕裂形态和位置、根据 Noyes 评分的软骨退变情况以及包括年龄、体重指数、性别和受伤日期在内的协变量。采用方差分析分析关节软骨退变严重程度与半月板撕裂形态的关系。采用回归分析分析软骨病变严重程度的预测因素。
方差分析显示，基于内侧半月板撕裂形态，关节软骨病变严重程度存在显著差异（P <.05）。与桶柄/垂直撕裂相比，根撕裂和放射状/瓣状撕裂与股骨内侧髁的退变显著相关；根撕裂和复杂撕裂与内侧胫骨平台的退变显著相关；放射状/瓣状撕裂与外侧胫骨平台的退变显著相关。年龄和性别是 Noyes 内侧间室评分的显著预测因素，年龄、体重指数和半月板撕裂形态是 Noyes 外侧间室评分的显著预测因素。
随着环状半月板纤维破坏程度的增加，半月板撕裂与膝关节内侧和外侧间室的软骨病变严重程度呈显著相关。
IV 级，预后病例系列。
