Sonnery-Cottet Bertrand, Mortati Rafael, Archbold Pooler, Gadea François, Clechet Julien, Thaunat Mathieu
Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France.
Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France.
Knee. 2014 Dec;21(6):1291-6. doi: 10.1016/j.knee.2014.07.001. Epub 2014 Jul 15.
Meniscal root avulsion has been predominantly reported in an adult population but little is known about this meniscal lesion in children and adolescents.
The of this article is to describe the clinical symptoms and a new MRI sign of a medial meniscus posterior root avulsion in skeletally immature patients, and to report the arthroscopic procedure for its reinsertion in the presence of open physes.
We report two skeletally immature patients who had a medial meniscus posterior root avulsion [MMPRA]. Diagnosis of a MMPRA was suspected on MRI by intense T2 hypersignal located at the postero-medial part of the tibial plateau reflecting trabecular bone oedema ("Bone bruise") at the level of the medial meniscal posterior root attachment. Arthroscopic reduction and fixation of the posterior root of the medial meniscus with transosseous sutures was performed. The patients returned to sport at the end of 6 months without residual symptoms. At one year, the radiographs showed no modification of the physis. Healing of the medial meniscal posterior root was noted on MRI.
In a skeletally immature patient it is important that this rare meniscal lesion is diagnosed early and adequately treated. We emphasize the importance of the indirect MRI signs that can lead a clinician to suspect the diagnosis of MMPRA. The aim of the surgery was to restore the anatomical footprint of the meniscal root and to re-establish its function thus preventing future chondral damage without damage to the tibial physeal growth plate.
Level IV.
半月板根部撕脱主要见于成人，而对于儿童和青少年的这种半月板损伤知之甚少。
本文旨在描述骨骼未成熟患者内侧半月板后根撕脱的临床症状和一种新的MRI征象，并报告在存在开放骨骺情况下对其进行重新植入的关节镜手术。
我们报告了两名骨骼未成熟患者，他们患有内侧半月板后根撕脱[MMPRA]。通过MRI怀疑MMPRA诊断，表现为位于胫骨平台后内侧部分的强烈T2高信号，反映了内侧半月板后根附着水平的小梁骨水肿（“骨挫伤”）。对内侧半月板后根进行了关节镜下复位并用经骨缝线固定。患者在6个月末恢复运动，无残留症状。一年时，X线片显示骨骺无改变。MRI显示内侧半月板后根愈合。
在骨骼未成熟患者中，早期诊断并充分治疗这种罕见的半月板损伤很重要。我们强调间接MRI征象的重要性，这些征象可使临床医生怀疑MMPRA的诊断。手术目的是恢复半月板根部的解剖足迹并重建其功能，从而预防未来的软骨损伤，同时不损伤胫骨骨骺生长板。
IV级。
