Kim Jae Hyan, Bin Seong-Il, Lee Bum-Sik, Kim Jong-Min, Kim Nam-Ki, Lee Chang-Rack
Department of Orthopedic Surgery, Baroseum Hospital, Daejeon, South Korea.
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 138-736, South Korea.
Arch Orthop Trauma Surg. 2018 Dec;138(12):1725-1730. doi: 10.1007/s00402-018-2987-9. Epub 2018 Jul 5.
Little is known about peripheral rim instability (PRI) of adult discoid lateral meniscus (DLM). We compared PRI of the intact DLM (iDLM) to those of intact normal lateral meniscus (LM) in adult patients and also investigated whether there was any association between PRI and DLM tears.
We investigated PRI in 17 DLMs and 60 normal LMs without tears during arthroscopic surgery for medial compartmental pathologies between June 2012 and October 2015. We also investigate PRI of torn DLM (tDLM) excluding peripheral tear to compare the PRI between intact and torn DLM. Stability parameters were measured using a probing hook and arthroscopic ruler at the anterior, middle, and posterior parts of the peripheral rim of the menisci: translating the anterior horn (AH) and mid-body (MB) and lifting the posterior horn (PH).
AH and PH instabilities were greater in the iDLM group than in the iLM group (2.2 ± 1.4 vs. 0.9 ± 1.4 mm, p = 0.006 and 3.4 ± 1.7 vs. 1.7 ± 1.2 mm, p = 0.004, respectively). However, there was no significant difference in MB instability between two groups. In addition, no significant difference was observed in all the parameters between the iDLM and tDLM groups.
Both iDLM and tDLM had greater PRI of the AH and PH than the iLM in adult patients. Thus, the DLM is prone to tear and careful inspection is needed not to overlook PRI of a DLM even if the peripheral attachment is intact.
Level 3, comparative study of anatomical instability of living subjects.
关于成人盘状外侧半月板（DLM）的周边缘不稳定（PRI），目前了解甚少。我们比较了成年患者中完整DLM（iDLM）与完整正常外侧半月板（LM）的PRI，并研究了PRI与DLM撕裂之间是否存在关联。
在2012年6月至2015年10月期间，我们对因内侧间室病变接受关节镜手术的17个DLM和60个无撕裂的正常LM进行了PRI研究。我们还研究了排除周边撕裂的撕裂DLM（tDLM）的PRI，以比较完整和撕裂DLM之间的PRI。使用探针钩和关节镜尺在半月板周边缘的前部、中部和后部测量稳定性参数：平移前角（AH）和半月板体中部（MB）以及抬起后角（PH）。
iDLM组的AH和PH不稳定性高于iLM组（分别为2.2±1.4 vs. 0.9±1.4 mm，p = 0.006和3.4±1.7 vs. 1.7±1.2 mm，p = 0.004）。然而，两组之间的MB不稳定性无显著差异。此外，iDLM组和tDLM组在所有参数上均未观察到显著差异。
在成年患者中，iDLM和tDLM的AH和PH的PRI均高于iLM。因此，DLM易于撕裂，即使周边附着完整，也需要仔细检查以免忽视DLM的PRI。
3级，活体解剖学不稳定性的比较研究。
