Barber F Alan, Getelman Mark H, Berry Kathy L
Plano Orthopedic Sports Medicine and Spine Center, Plano, Texas, U.S.A.
Southern California Orthopedic Institute, Van Nuys, California, U.S.A.
Arthroscopy. 2017 Apr;33(4):783-789. doi: 10.1016/j.arthro.2016.09.027. Epub 2016 Dec 16.
To determine whether an association exists between a biconcave medial tibial plateau and complex medial meniscus tears.
A consecutive series of stable knees undergoing arthroscopy were evaluated retrospectively with the use of preoperative magnetic resonance imaging (MRI), radiographs, and arthroscopy documented by intraoperative videos. Investigators independently performed blinded reviews of the MRI or videos. Based on the arthroscopy findings, medial tibial plateaus were classified as either biconcave or not biconcave. A transverse coronal plane ridge, separating the front of the tibial plateau from the back near the inner margin of the posterior body of the medial meniscus, was defined as biconcave. The medial plateau slope was calculated with MRI sagittal views. General demographic information, body mass index, and arthroscopically confirmed knee pathology were recorded.
A total of 179 consecutive knees were studied from July 2014 through August 2015; 49 (27.2%) biconcave medial tibial plateaus and 130 (72.8%) controls were identified at arthroscopy. Complex medial meniscus tears were found in 103. Patients with a biconcave medial tibial plateau were found to have more complex medial meniscus tears (69.4%) than those without a biconcavity (53.1%) (P = .049) despite having lower body mass index (P = .020). No difference in medial tibial plateau slope was observed for biconcavities involving both cartilage and bone, bone only, or an indeterminate group (P = .47).
Biconcave medial tibial plateaus were present in 27.4% of a consecutive series of patients undergoing knee arthroscopy. A biconcave medial tibial plateau was more frequently associated with a complex medial meniscus tear.
Level III, case-control study.
确定双凹形内侧胫骨平台与复杂内侧半月板撕裂之间是否存在关联。
回顾性评估一系列连续接受关节镜检查的稳定膝关节，使用术前磁共振成像（MRI）、X线片以及术中视频记录的关节镜检查资料。研究人员独立对MRI或视频进行盲法评估。根据关节镜检查结果，将内侧胫骨平台分为双凹形或非双凹形。在内侧半月板后体部内缘附近，将分隔胫骨平台前部与后部的横向冠状面嵴定义为双凹形。利用MRI矢状位视图计算内侧平台斜率。记录一般人口统计学信息、体重指数以及关节镜确诊的膝关节病变情况。
2014年7月至2015年8月共研究了179例连续的膝关节；关节镜检查发现49例（27.2%）双凹形内侧胫骨平台和130例（72.8%）对照。103例患者发现有复杂内侧半月板撕裂。尽管体重指数较低（P = .020），但双凹形内侧胫骨平台患者的复杂内侧半月板撕裂发生率（69.4%）高于无双凹形者（53.1%）（P = .049）。对于涉及软骨和骨、仅涉及骨或不确定组的双凹形，内侧胫骨平台斜率未观察到差异（P = .47）。
在一系列连续接受膝关节镜检查的患者中，27.4%存在双凹形内侧胫骨平台。双凹形内侧胫骨平台更常与复杂内侧半月板撕裂相关。
III级，病例对照研究。
