Yamagami Ryota, Taketomi Shuji, Inui Hiroshi, Tahara Keitaro, Tanaka Sakae
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Knee. 2017 Mar;24(2):390-395. doi: 10.1016/j.knee.2016.12.004. Epub 2017 Feb 4.
Medial meniscus posterior root tear (MMPRT) has been reported to play a key role in the development of spontaneous osteonecrosis of the knee (SONK) and osteoarthritis (OA) of the knee. However, little is known about the differences in the development of SONK and OA after MMPRT. The purpose of this study was to investigate the factors contributing to the development of these conditions.
We evaluated the existence of MMPRT and the extent of medial meniscal extrusion in preoperative magnetic resonance images and proximal tibial morphology in radiographs of 45 patients with SONK and 104 patients with OA who underwent knee surgery.
There were no significant differences in age, gender, height, weight, and body mass index between the two groups. The incidence of MMPRT and the mean posterior tibial slope (PTS) were significantly higher in SONK than in OA patients (62.2% versus 34.3%, P=0.002, and 12.8° versus 10.5°, P<0.001, respectively). The mean extent of meniscal extrusion was larger in OA than in SONK patients (7.5mm versus 5.3mm, P<0.001). The mean tibial varus angle was 4.8° in SONK and 5.4° in OA, with no significant difference between the two (P=0.088). Multivariable logistic regression analysis showed that compared with OA, SONK was more closely associated with the existence of MMPRT and had a smaller extent of medial meniscus extrusion and higher PTS.
MMRPT and higher PTS were more closely associated with the development of SONK than with that of OA.
据报道，内侧半月板后根部撕裂（MMPRT）在膝关节自发性骨坏死（SONK）和膝关节骨关节炎（OA）的发展中起关键作用。然而，关于MMPRT后SONK和OA发展的差异知之甚少。本研究的目的是调查导致这些疾病发展的因素。
我们评估了45例接受膝关节手术的SONK患者和104例OA患者术前磁共振成像中MMPRT的存在情况、内侧半月板挤出程度以及X线片中胫骨近端形态。
两组患者在年龄、性别、身高、体重和体重指数方面无显著差异。SONK患者中MMPRT的发生率和平均胫骨后倾角（PTS）显著高于OA患者（分别为62.2%对34.3%，P = 0.002；12.8°对10.5°，P < 0.001）。OA患者的半月板平均挤出程度大于SONK患者（7.5mm对5.3mm，P < 0.001）。SONK患者的平均胫骨内翻角为4.8°，OA患者为5.4°，两者之间无显著差异（P = 0.088）。多变量逻辑回归分析显示，与OA相比，SONK与MMPRT的存在更密切相关，内侧半月板挤出程度更小，PTS更高。
MMRPT和更高的PTS与SONK的发展比与OA的发展更密切相关。
