Kodama Yuya, Furumatsu Takayuki, Miyazawa Shinichi, Fujii Masataka, Tanaka Takaaki, Inoue Hiroto, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
J Orthop Res. 2017 Aug;35(8):1625-1633. doi: 10.1002/jor.23450. Epub 2017 May 2.
The anterior root of the lateral meniscus provides functional stability to the meniscus. In this study, we evaluated the relationship between the position of the tibial tunnel and extrusion of the lateral meniscus after anterior cruciate ligament reconstruction, where extrusion provides a proxy measure of injury to the anterior root. The relationship between extrusion and tibial tunnel location was retrospectively evaluated from computed tomography and magnetic resonance images of 26 reconstructed knees, contributed by 25 patients aged 17-31 years. A measurement grid was used to localize the position of the tibial tunnel based on anatomical landmarks identified from the three-dimensional reconstruction of axial computed tomography images of the tibial plateaus. The reference point-to-tibial tunnel distance (mm) was defined as the distance from the midpoint of the lateral edge of the grid to the posterolateral aspect of the tunnel aperture. The optimal cutoff of this distance to minimize post-operative extrusion was identified using receiver operating curve analysis. Extrusion of the lateral meniscus was positively correlated to the reference point-to-tibial tunnel distance (r = 0.64; p < 0.001), with a cutoff distance of 5 mm having a sensitivity to extrusion of 83% and specificity of 93%. The mean extrusion for a distance >5 mm was 0.40 ± 0.43 mm, compared to 1.40 ± 0.51 mm for a distance ≤5 mm (p < 0.001). Therefore, a posterolateral location of the tibial tunnel aperture within the footprint of the anterior cruciate ligament decreases the reference point-to-tibial tunnel distance and increases extrusion of the lateral meniscus post-reconstruction. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1625-1633, 2017.
外侧半月板前根为半月板提供功能稳定性。在本研究中，我们评估了前交叉韧带重建术后胫骨隧道位置与外侧半月板挤出之间的关系，其中挤出可作为前根损伤的替代指标。通过对25例年龄在17 - 31岁患者的26个重建膝关节的计算机断层扫描和磁共振图像进行回顾性分析，评估挤出与胫骨隧道位置之间的关系。基于从胫骨平台轴向计算机断层扫描图像的三维重建中识别出的解剖标志，使用测量网格来定位胫骨隧道的位置。参考点到胫骨隧道的距离（毫米）定义为从网格外侧边缘中点到隧道开口后外侧的距离。使用受试者工作特征曲线分析确定该距离的最佳截断值，以最小化术后挤出。外侧半月板的挤出与参考点到胫骨隧道的距离呈正相关（r = 0.64；p < 0.001），截断距离为5毫米时，对挤出的敏感性为83%，特异性为93%。距离>5毫米时的平均挤出为0.40±0.43毫米，而距离≤5毫米时为1.40±0.51毫米（p < 0.001）。因此，在前交叉韧带足迹内胫骨隧道开口的后外侧位置会减小参考点到胫骨隧道的距离，并增加重建后外侧半月板的挤出。©2016骨科研究协会。由威利期刊公司出版。《骨科研究杂志》35:1625 - 1633，2017。
