Ahn Jin Hwan, Wang Joon Ho, Kim Dong Uk, Lee Do Kyung, Kim Jun Ho
Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Knee. 2017 Dec;24(6):1350-1358. doi: 10.1016/j.knee.2017.07.012. Epub 2017 Aug 17.
The aim of this study was to evaluate the relationship between discoid lateral meniscus (DLM) types based on peripheral detachment and anatomic features of Wrisberg ligament (WL) such as location and thickness based on magnetic resonance image (MRI).
A total of 322 knees in 292 patients were reviewed. Patients were divided into four DLM types according to peripheral detachment: no shift (type 1), anterocentral shift (type 2), posterocentral shift (type 3) and central shift (type 4). We reviewed all MRI concentrating on the presence, location (high or low location), running angle, thickness of WL, and WL/posterior cruciate ligament (PCL) thickness ratio. The relationship between DLM types and anatomic features of WL were analyzed using one-way analysis of variance and chi-square test.
According to DLM types based on peripheral detachment, 149 knees were type 1, 38 were type 2, 79 were type 3, and 56 were type 4. Among the 322 knees, 302 (93.8%) had WL on MRI. In DLM patients, type 3 showed a statistically significant (P<0.001) relationship with high location of WL. In addition, type 3 had significantly larger (P<0.0001) running angle of WL, thicker (P<0.0001) WL, and higher (P<0.0001) WL/PCL ratio compared to other types.
A high location and thick WL are related to posterocentral shift type of DLM based on peripheral detachment. Based on our results, the high location and thick WL might provide information to surgeons in predicting the direction of peripheral detachment in symptomatic DLM patients.
本研究旨在基于磁共振成像(MRI)评估基于外周分离的盘状外侧半月板(DLM)类型与Wrisberg韧带(WL)的解剖特征(如位置和厚度)之间的关系。
回顾了292例患者的322个膝关节。根据外周分离情况将患者分为四种DLM类型:无移位(1型)、前中央移位(2型)、后中央移位(3型)和中央移位(4型)。我们回顾了所有MRI,重点关注WL的存在、位置(高位或低位)、走行角度、厚度以及WL/后交叉韧带(PCL)厚度比。使用单因素方差分析和卡方检验分析DLM类型与WL解剖特征之间的关系。
根据基于外周分离的DLM类型,149个膝关节为1型,38个为2型,79个为3型,56个为4型。在322个膝关节中,302个(93.8%)在MRI上显示有WL。在DLM患者中,3型与WL高位存在统计学显著关系(P<0.001)。此外,与其他类型相比,3型的WL走行角度明显更大(P<0.0001),WL更厚(P<0.0001),WL/PCL比更高(P<0.0001)。
基于外周分离,高位且厚的WL与DLM的后中央移位类型相关。根据我们的结果,高位且厚的WL可能为外科医生预测有症状DLM患者外周分离方向提供信息。