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前交叉韧带重建同期行外侧半月板修复会导致外侧半月板挤出:磁共振成像评估

Concurrent Lateral Meniscal Repair with Anterior Cruciate Ligament Reconstruction Induces the Extrusion of the Lateral Meniscus: Assessments of Magnetic Resonance Images.

作者信息

Kashihara Naoko, Furumatsu Takayuki, Kodama Yuya, Tanaka Takaaki, Ozaki Toshifumi

机构信息

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Siences, Okayama 700-8558, Japan.

出版信息

Acta Med Okayama. 2016 Dec;70(6):441-448. doi: 10.18926/AMO/54806.

Abstract

Concurrent meniscal repair with anterior cruciate ligament (ACL) reconstruction has shown good clinical outcomes, but it has a considerable risk of progressing to post-traumatic osteoarthritis of the knee. Here we investigated postoperative changes in the position of the lateral meniscus (LM) and assessed the short-term clinical results after concurrent LM repair with ACL reconstruction. Twentyseven patients underwent LM repair of a peripheral longitudinal tear concomitant with ACL reconstruction. We evaluated the preoperative and postoperative values of the Lysholm score and anteroposterior instability. The length and width of the lateral tibial plateau were determined by radiographic images. The length, width, body width, extrusion, and height of the LM were measured in magnetic resonance images and compared between the preoperative and postoperative measurements. Our analysis revealed that concurrent LM repair with ACL reconstruction improved the shortterm clinical outcomes. Although the body width and height of the LM did not change, the postoperative LM extrusion and LM width were significantly increased after the surgery. The post-traumatic transposition of the LM may not be completely prevented by LM repair concomitant with ACL reconstruction.

摘要

前交叉韧带(ACL)重建同时进行半月板修复已显示出良好的临床效果,但有相当大的风险发展为创伤后膝关节骨关节炎。在此,我们研究了外侧半月板(LM)位置的术后变化,并评估了ACL重建同时进行LM修复后的短期临床结果。27例患者接受了伴有ACL重建的周围纵向撕裂的LM修复。我们评估了Lysholm评分和前后不稳定的术前和术后值。通过X线图像确定外侧胫骨平台的长度和宽度。在磁共振图像中测量LM的长度、宽度、体宽、挤压和高度,并在术前和术后测量之间进行比较。我们的分析表明,ACL重建同时进行LM修复改善了短期临床结果。尽管LM的体宽和高度没有变化,但术后LM挤压和LM宽度在手术后显著增加。ACL重建同时进行LM修复可能无法完全防止创伤后LM的移位。

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