Suga Norifumi, Nakasa Tomoyuki, Ishikawa Masakazu, Nakamae Atsuo, Hayashi Seiju, Yoshikawa Masahiro, Sumida Yoshikazu, Tsuyuguchi Yusuke, Adachi Nobuo
Dept. of Orthop. Surg., University of Hiroshima, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan.
Dept. of Orthop. Surg., University of Hiroshima, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Hiroshima, Japan.
Knee. 2018 Dec;25(6):1027-1032. doi: 10.1016/j.knee.2018.07.019. Epub 2018 Aug 11.
Patients with discoid lateral meniscus (DLM) are prone to meniscal injuries related to its shape and abnormal mobility. The anatomical joint inclination of the proximal tibiofibular joint (PTFJ) can also affect joint movement in knee motion. However, an association between PTFJ morphology and DLM remains unclear. The purpose of this study was to investigate the morphology of the PTFJ on MRI and how this differs between patients with and without DLM.
Fifty-eight patients with DLM and 58 age-matched controls (normal meniscus) were included in this study. Slices from preoperative MRI sagittal images that clearly showed the PTFJ were used for measurements. The angle between the PTFJ and the perpendicular line of the fibula axis was measured as the inclination angle, and patients were classified as horizontal-type (<20°) or oblique-type (>20°). The inclination angle was also compared among patients with open and closed epiphysis in both groups to assess the effect of age.
Patients in the horizontal-type PTFJ group frequently had DLM. Before epiphyseal closure, most patients had a horizontal-type PTFJ, with or without DLM. However, in older patients with a closed epiphysis, most with a normal meniscus had an oblique-type PTFJ, and those with DLM retained the horizontal-type joint.
The horizontal-type PTFJ was significantly associated with DLM, and patients with DLM tended to retain a horizontal-type PTFJ after epiphyseal closure. In contrast, in patients with a normal meniscus, the PTFJ may change from a horizontal-type to an oblique-type PTFJ in line with bone maturity.
盘状外侧半月板（DLM）患者因其形状和异常活动度而易发生半月板损伤。胫腓近侧关节（PTFJ）的解剖学关节倾斜度也会影响膝关节运动中的关节活动。然而，PTFJ形态与DLM之间的关联仍不清楚。本研究的目的是调查MRI上PTFJ的形态，以及DLM患者与非DLM患者之间的形态差异。
本研究纳入了58例DLM患者和58例年龄匹配的对照组（半月板正常）。术前MRI矢状位图像中清晰显示PTFJ的切片用于测量。将PTFJ与腓骨轴线垂线之间的角度测量为倾斜角，患者分为水平型（<20°）或斜型（>20°）。还比较了两组中骨骺开放和闭合患者的倾斜角，以评估年龄的影响。
水平型PTFJ组患者常患有DLM。在骨骺闭合之前，大多数患者的PTFJ为水平型，无论是否患有DLM。然而，在骨骺闭合的老年患者中，大多数半月板正常的患者PTFJ为斜型，而患有DLM的患者则保持水平型关节。
水平型PTFJ与DLM显著相关，DLM患者在骨骺闭合后倾向于保持水平型PTFJ。相比之下，半月板正常的患者，PTFJ可能会随着骨骼成熟从水平型转变为斜型。
