Szarmach Arkadiusz, Luczkiewicz Piotr, Skotarczak Monika, Kaszubowski Mariusz, Winklewski Pawel J, Dzierzanowski Jaroslaw, Piskunowicz Maciej, Szurowska Edyta, Baczkowski Bogusław
2-nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
2-nd Clinic of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdansk, Gdansk, Poland.
PLoS One. 2016 Jul 14;11(7):e0159156. doi: 10.1371/journal.pone.0159156. eCollection 2016.
Meniscus extrusion is a serious and relatively frequent clinical problem. For this reason the role of different risk factors for this pathology is still the subject of debate. The goal of this study was to verify the results of previous theoretical work, based on the mathematical models, regarding a relationship between the cross-section shape of the meniscus and the risk of its extrusion.
Knee MRI examination was performed in 77 subjects (43 men and 34 women), mean age 34.99 years (range: 18-49 years), complaining of knee pain. Patients with osteoarthritic changes (grade 3 and 4 to Kellgren classification), varus or valgus deformity and past injuries of the knee were excluded from the study. A 3-Tesla MR device was used to study the relationship between the shape of the lateral meniscus (using slope angle, meniscus-cartilage height and meniscus-bone angle) and the risk of extrusion.
Analysis revealed that with values of slope angle and meniscus-bone angle increasing by one degree, the risk of meniscus extrusion raises by 1.157 and 1.078 respectively. Also, an increase in meniscus-cartilage height by 1 mm significantly elevates the risk of extrusion. At the same time it was demonstrated that for meniscus-bone angle values over 42 degrees and slope angle over 37 degrees the risk of extrusion increases significantly.
This was the first study to demonstrate a tight correlation between slope angle, meniscus-bone angle and meniscus-cartilage height values in the assessment of the risk of lateral meniscus extrusion. Insertion of the above parameters to the radiological assessment of the knee joint allows identification of patients characterized by an elevated risk of development of this pathology.
半月板挤压是一个严重且相对常见的临床问题。因此，不同风险因素在该病理过程中的作用仍是争论的焦点。本研究的目的是验证基于数学模型的先前理论研究结果，即半月板横截面形状与其挤压风险之间的关系。
对77名主诉膝关节疼痛的受试者（43名男性和34名女性）进行了膝关节MRI检查，平均年龄34.99岁（范围：18 - 49岁）。排除患有骨关节炎改变（Kellgren分级为3级和4级）、膝内翻或膝外翻畸形以及既往有膝关节损伤的患者。使用3特斯拉MR设备研究外侧半月板形状（采用倾斜角、半月板 - 软骨高度和半月板 - 骨角度）与挤压风险之间的关系。
分析显示，倾斜角和半月板 - 骨角度的值每增加1度，半月板挤压风险分别增加1.157和1.078。此外，半月板 - 软骨高度每增加1毫米，挤压风险显著升高。同时还表明，当半月板 - 骨角度值超过42度且倾斜角超过37度时，挤压风险显著增加。
这是第一项在评估外侧半月板挤压风险时证明倾斜角、半月板 - 骨角度和半月板 - 软骨高度值之间存在紧密相关性的研究。将上述参数纳入膝关节的放射学评估中，能够识别出具有该病理发展高风险特征的患者。
