Masuda Shin, Furumatsu Takayuki, Okazaki Yoshiki, Kamatsuki Yusuke, Okazaki Yuki, Kodama Yuya, Hiranaka Takaaki, Nakata Eiji, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Acta Med Okayama. 2019 Dec;73(6):495-501. doi: 10.18926/AMO/57713.
Medial meniscus posterior root tear causes rapid knee cartilage degradation by inducing posteromedial displacement of the medial meniscus. We evaluated medial meniscus posterior extrusion before and after pullout repair for medial meniscus posterior root tear using magnetic resonance images. Twenty-eight patients with symptomatic medial meniscus posterior root tear were included. The inclusion criteria were: acute (< 3 months) or chronic (≥3 months) medial meniscus posterior root tear after painful popping events. The exclusion criteria were: other meniscus and anterior cruciate ligament injuries. We measured medial meniscus posterior extrusion and medial meniscus anteroposterior interval at knee flexion angles of 10° and 90° preoperatively and at 3 months postoperatively. The posterior extrusion at 90° knee flexion decreased from 4.42±1.38 mm preoperatively to 3.09±1.06 mm (p<0.001) postoperatively, while at 10° knee flexion it was -4.17±1.63 mm preoperatively and -3.77±1.72mm postoperatively, showing no significant change. The anteroposterior interval at 10° knee flexion increased from 19.74±4.27 mm preoperatively to 22.15±5.10 mm postoperatively (p<0.001); at 90° knee flexion, it increased from 16.81±4.51 mm preoperatively to 19.20±4.30 mm postoperatively (p<0.001). Medial meniscus posterior extrusion and movement decreased after pullout repair. Pullout repair for medial meniscus posterior root tear improves medial meniscus posterior extrusion, especially at 90° knee flexion.
内侧半月板后根撕裂通过引起内侧半月板后内侧移位导致膝关节软骨快速退变。我们使用磁共振成像评估了内侧半月板后根撕裂患者在拔出修复术前和术后的内侧半月板后移情况。纳入了28例有症状的内侧半月板后根撕裂患者。纳入标准为:在疼痛性弹响事件后急性(<3个月)或慢性(≥3个月)内侧半月板后根撕裂。排除标准为:其他半月板和前交叉韧带损伤。我们在术前以及术后3个月测量了膝关节屈曲10°和90°时的内侧半月板后移和内侧半月板前后间隙。膝关节屈曲90°时的后移从术前的4.42±1.38mm降至术后的3.09±1.06mm(p<0.001),而膝关节屈曲10°时术前为-4.17±1.63mm,术后为-3.77±1.72mm,无显著变化。膝关节屈曲10°时的前后间隙从术前的19.74±4.27mm增加至术后的22.15±5.10mm(p<0.001);膝关节屈曲90°时,从术前的16.81±4.51mm增加至术后的19.20±4.30mm(p<0.001)。拔出修复术后内侧半月板后移及移动减少。内侧半月板后根撕裂的拔出修复改善了内侧半月板后移,尤其是在膝关节屈曲90°时。