Ohishi Tsuyoshi, Suzuki Daisuke, Yamamoto Kazufumi, Banno Tomohiro, Shimizu Yuta, Matsuyama Yukihiro
The Department of Orthopaedic Surgery, Enshu Hospital, Hamamatsu, Shizuoka, Japan.
The Department of Orthopaedic Surgery, Enshu Hospital, Hamamatsu, Shizuoka, Japan.
Knee. 2014 Jan;21(1):112-8. doi: 10.1016/j.knee.2013.02.003. Epub 2013 Apr 25.
To evaluate medial extrusion of the posterior segment of the medial meniscus in posterior horn tears.
This study enrolled 72 patients without medial meniscal tears (group N), 72 patients with medial meniscal tears without posterior horn tears (group PH-), 44 patients with posterior horn tears of the medial meniscus (group PH+). All meniscal tears were confirmed by arthroscopy. Medial extrusion of the middle segment and the posterior segment was measured on coronal MRIs.
Extrusions of both middle and posterior segments in groups PH- and PH+ (middle segment; 2.94±1.51 mm for group PH- and 3.75±1.69 mm for group PH+, posterior segment; 1.85±1.82 mm for group PH- and 4.59±2.74 mm for group PH+) were significantly larger than those in group N (middle segment; 2.04±1.20, posterior segment; 1.21±1.86). Both indicators of extrusion in group PH+ were larger than those in group PH-. In the early OA category, neither middle nor posterior segment in group PH- extruded more than in group N. However, only the posterior segment in group PH+ extruded significantly more than in group N. Multiple lineal regression analyses revealed that posterior segment extrusion was strongly correlated with the posterior horn tears (p<0.001) among groups PH- and PH+.
The newly presented indicator for extrusion of the posterior segment of the medial meniscus is associated with posterior horn tears in comparison with the extrusion of the middle segment, especially in the early stages of osteoarthritis.
Level II--Diagnostic Study.
评估内侧半月板后角撕裂时内侧半月板后段的内侧移位情况。
本研究纳入72例无内侧半月板撕裂的患者(N组)、72例有内侧半月板撕裂但无后角撕裂的患者(PH-组)、44例有内侧半月板后角撕裂的患者(PH+组)。所有半月板撕裂均经关节镜检查确诊。在冠状位磁共振成像上测量内侧段和后段的内侧移位情况。
PH-组和PH+组的中段和后段移位(中段;PH-组为2.94±1.51mm,PH+组为3.75±1.69mm;后段;PH-组为1.85±1.82mm,PH+组为4.59±2.74mm)均显著大于N组(中段;2.04±1.20,后段;1.21±1.86)。PH+组的两个移位指标均大于PH-组。在早期骨关节炎类别中,PH-组的中段和后段移位均未比N组更明显。然而,只有PH+组的后段移位比N组显著更明显。多元线性回归分析显示,在PH-组和PH+组中,后段移位与后角撕裂密切相关(p<0.001)。
与中段移位相比,新提出的内侧半月板后段移位指标与后角撕裂相关,尤其是在骨关节炎早期。
二级——诊断性研究。