前内侧半月板突出-后交叉韧带缺失的间接征象。

Protruding anterior medial meniscus-An indirect sign of posterior cruciate ligament deficiency.

机构信息

Radiology Department, Haraldsplass Deaconess Hospital, Ulriksdal 8, N-5009 Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Postboks 7804, N-5020, Bergen, Norway.

Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Postboks 7804, N-5020, Bergen, Norway.

出版信息

Eur J Radiol. 2018 Feb;99:146-153. doi: 10.1016/j.ejrad.2017.12.026. Epub 2018 Jan 1.

DOI:10.1016/j.ejrad.2017.12.026

PMID:29362146

Abstract

BACKGROUND

to examine if PROTruding of the Anterior Medial Meniscus (PROTAMM) could be an indirect sign of PCL deficiency by comparing PROTAMM to passive posterior tibial sagging (PSS) for chronic PCL rupture on routine MRI.

METHODS

Patients with PCL reconstruction between 2011 and 2016 were included in a case control study. Primarily cases with combined ACL/PCL injury were excluded. Secondary exclusion criteria were bony fractures, medial meniscus pathology and poor quality MRIs. Three (blinded) observers reviewed the pre-operative MRIs according to a pre-defined protocol.

RESULTS

After applying the inclusion and primary exclusion criteria 16 patients were identified in the PCL rupture group. The control group consisted of 15 patients. After reviewing the MRIs, 6 were excluded due to secondary exclusion criteria. Mean PPS measured 4.8 mm (± 4.4 mm) in the PCL rupture group and 1.8 mm (±2.9 mm) in the control group, p = 0.05. Mean PROTAMM was 3.6 mm (±0.6 mm) in the PCL rupture group and 0.7 mm (±0.9 mm) in the control group, p = 0.004.

CONCLUSION

We found a mean PROTAMM of 3.6 mm in patients with PCL rupture. We suggest that this sign, after knee injury in an otherwise normal medial meniscus, is a promising indirect sign of PCL deficiency compared to PPS. Implementation of this sign in clinical practice may improve the sensitivity of routine non-weight bearing MRI in identifying PCL deficient knees.

摘要

背景

通过比较 PROTruding 的前内侧半月板（PROTAMM）与被动胫骨后沉（PSS）在常规 MRI 上慢性 PCL 撕裂中的表现，来探究 PROTAMM 是否可作为 PCL 缺失的间接征象。

方法

纳入了 2011 年至 2016 年接受 PCL 重建的患者进行病例对照研究。主要排除 ACL/PCL 合并损伤的病例。次要排除标准为骨骨折、内侧半月板病变和 MRI 质量差。三名（盲法）观察者根据预先设定的方案对术前 MRI 进行了评估。

结果

根据纳入标准和主要排除标准，共确定了 16 例 PCL 撕裂患者进入 PCL 撕裂组。对照组由 15 例患者组成。在对 MRI 进行复查后，有 6 例因次要排除标准而被排除。PCL 撕裂组的平均 PPS 为 4.8 mm（±4.4 mm），对照组为 1.8 mm（±2.9 mm），p=0.05。PCL 撕裂组的平均 PROTAMM 为 3.6 mm（±0.6 mm），对照组为 0.7 mm（±0.9 mm），p=0.004。