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后半月板根部撕裂:辅助作为诊断工具的相关病变

Posterior meniscus root tears: associated pathologies to assist as diagnostic tools.

作者信息

Matheny Lauren M, Ockuly Andrew C, Steadman J Richard, LaPrade Robert F

机构信息

Steadman Philippon Research Institute, 181 W. Meadow Dr. Ste. 1000, Vail, CO, 81657, USA.

The Steadman Clinic, 181 W. Meadow Dr. Ste. 400, Vail, CO, 81657, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Oct;23(10):3127-31. doi: 10.1007/s00167-014-3073-7. Epub 2014 May 28.

Abstract

PURPOSE

The purpose of this study was to investigate associated pathologies identified at arthroscopy in patients with meniscus root tears.

METHODS

This study was Institutional Review Board approved. All patients who underwent arthroscopic knee surgery where a complete meniscus root tear was identified were included in this study. Concurrent ligament tears and articular cartilage changes ≥Outerbridge grade 2 were recorded and stored in a data registry.

RESULTS

Fifty patients (28 males, 22 females) [mean age = 36.5 years (range 17.1-68.1 years)] who were diagnosed with a medial or lateral meniscus root tear at arthroscopy were included in this study out of 673 arthroscopic surgeries (prevalence 7.4 %). Twenty-three (46 %) patients had a medial meniscus root tear, 26 (52 %) patients had a lateral meniscus root tear and one (2 %) patient had both. Thirty-four per cent of patients (n = 17) underwent partial meniscectomy, while 60 % (n = 31) underwent suture repair. During arthroscopy, 60 % (n = 30) of patients were diagnosed with an anterior cruciate ligament (ACL) tear. Patients with lateral meniscus root tears were 10.3 times (95 % CI 2.6-42.5) more likely to have ACL tears than patients with medial meniscus root tears (p = 0.012). Patients who had medial meniscus root tears were 5.8 times (95 % CI 1.6-20.5) more likely to have chondral defects than patients who had lateral meniscus root tears (p = 0.044).

CONCLUSION

In this study, patients' preoperative functional scores and activity levels were low. Patients with lateral meniscal root tears were more likely to have an ACL tear. Patients with medial meniscal root tears were more likely to have an knee articular cartilage defect with an Outerbridge grade 2 or higher chondral defect. This study confirms the importance of comprehensive assessment of concurrent injuries to properly diagnose meniscus root tears.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究旨在调查半月板根部撕裂患者在关节镜检查中发现的相关病变。

方法

本研究经机构审查委员会批准。所有接受膝关节镜手术且被确诊为半月板根部完全撕裂的患者均纳入本研究。同时记录并存的韧带撕裂和关节软骨改变(≥Outerbridge 2级)并存储于数据登记处。

结果

在673例关节镜手术中,有50例(28例男性,22例女性)[平均年龄 = 36.5岁(范围17.1 - 68.1岁)]在关节镜检查时被诊断为内侧或外侧半月板根部撕裂,纳入本研究(患病率7.4%)。23例(46%)患者为内侧半月板根部撕裂,26例(52%)患者为外侧半月板根部撕裂,1例(2%)患者双侧均有撕裂。34%的患者(n = 17)接受了部分半月板切除术,而60%(n = 31)接受了缝合修复。在关节镜检查期间,60%(n = 30)的患者被诊断为前交叉韧带(ACL)撕裂。外侧半月板根部撕裂的患者发生ACL撕裂的可能性是内侧半月板根部撕裂患者的10.3倍(95%可信区间2.6 - 42.5)(p = 0.012)。内侧半月板根部撕裂的患者发生软骨缺损的可能性是外侧半月板根部撕裂患者的5.8倍(95%可信区间1.6 - 20.5)(p = 0.044)。

结论

在本研究中,患者术前功能评分和活动水平较低。外侧半月板根部撕裂的患者更有可能发生ACL撕裂。内侧半月板根部撕裂的患者更有可能出现膝关节软骨缺损,软骨缺损程度为Outerbridge 2级或更高。本研究证实了全面评估并发损伤对正确诊断半月板根部撕裂的重要性。

证据级别

IV级。

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