Department of Orthopedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, South Korea.
Arthroscopy. 2013 Mar;29(3):545-9. doi: 10.1016/j.arthro.2012.10.026. Epub 2013 Jan 29.
The purpose of this study was to determine the accuracy, sensitivity, specificity, and predictive values of a single event of painful popping in the presence of a posterior root tear of the medial meniscus in middle-aged to older Asian patients.
We conducted a retrospective review of medical records of 936 patients who underwent arthroscopic surgeries for an isolated medial meniscus tear between January 2000 and December 2010. There were 332 men and 604 women with a mean age of 41 years (range, 25 to 66 years). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of a painful popping sensation for a posterior root tear of the medial meniscus were calculated.
Arthroscopy confirmed the presence of posterior root tears of the medial menisci in 237 of 936 patients (25.3%). A single event of a painful popping sensation was present in 86 of these 936 patients (9.1%). Of these 86 patients with a painful popping sensation, 83 (96.5%) were categorized as having an isolated posterior root tear of the medial meniscus. The positive predictive value of a painful popping sensation in identifying a posterior root tear of the medial meniscus was 96.5%, the negative predictive value was 81.8%, the sensitivity was 35.0%, the specificity was 99.5%, and the diagnostic accuracy was 77.9%.
A single event of painful popping can be a highly predictive clinical sign of a posterior root tear of the medial meniscus in the middle-aged to older Asian population. However, it has low sensitivity for the detection of a posterior root tear of the medial meniscus.
Level IV, therapeutic case series.
本研究旨在确定在中年至老年亚洲患者中，内侧半月板后根部撕裂时出现单次疼痛弹响声的准确性、敏感度、特异性和预测值。
我们对 2000 年 1 月至 2010 年 12 月期间接受关节镜手术治疗的 936 例孤立性内侧半月板撕裂患者的病历进行了回顾性分析。其中男性 332 例，女性 604 例，平均年龄 41 岁（25 至 66 岁）。计算了疼痛弹响声对内侧半月板后根部撕裂的准确性、敏感度、特异性、阳性预测值和阴性预测值。
关节镜检查证实 936 例患者中有 237 例（25.3%）存在内侧半月板后根部撕裂。在这 936 例患者中，有 86 例（9.1%）出现单次疼痛弹响声。在这 86 例有疼痛弹响声的患者中，83 例（96.5%）被归类为存在孤立性内侧半月板后根部撕裂。疼痛弹响声识别内侧半月板后根部撕裂的阳性预测值为 96.5%，阴性预测值为 81.8%，敏感度为 35.0%，特异性为 99.5%，诊断准确性为 77.9%。
在中年至老年亚洲人群中，单次疼痛弹响可能是内侧半月板后根部撕裂的高度预测性临床体征。然而，它对内侧半月板后根部撕裂的检测敏感度较低。
IV 级，治疗性病例系列。
