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在解剖型单束前交叉韧带重建术中,女性小骨架患者可能会发生前交叉韧带前根半月板前外侧部分撕裂。

Partial lateral meniscus anterior root injuries during anatomical single-bundle anterior cruciate ligament reconstruction are likely to occur in women with small skeletons.

机构信息

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Nov;28(11):3517-3523. doi: 10.1007/s00167-020-05896-8. Epub 2020 Feb 14.

Abstract

PURPOSE

This study aimed to investigate the occurrence and characteristics of lateral meniscus anterior root injuries during anatomical single-bundle anterior cruciate ligament (ACL) reconstruction.

METHODS

Between 2011 and 2018, 70 women who had ACL injuries without lateral meniscal tears underwent anatomical single-bundle ACL reconstruction. Using computed tomography, the anatomical relationship between the predicted lateral meniscus anterior root insertion and the tibial tunnel was retrospectively assessed, and the patients were divided into partial lateral meniscus anterior root injury and intact groups. The demographic characteristics, the distances between bony landmarks, the tibial tunnel sizes, and lateral meniscal extrusion assessed by magnetic resonance imaging were compared between the two groups.

RESULTS

Thirteen of the 70 patients had suspected partial lateral meniscus anterior root injuries. Patient height was significantly shorter in the injury group than in the intact group (157.7 ± 6.4 vs. 161.4 ± 5.4 cm: p = 0.03); the distance from the apex to the bottom of the slope of the medial intercondylar ridge was significantly shorter in the injury group than in the intact group (15.1 ± 1.9 vs. 16.7 ± 1.4 mm: p = 0.001).

CONCLUSIONS

Partial lateral meniscus anterior root injury during anatomical single-bundle ACL reconstruction was suspected in 18% of cases. Patient height and the distance between bony landmarks were significantly shorter in the injury group than in the intact group. Surgeons should understand that even a slight deviation of the tibial tunnel position can lead to partial lateral meniscus anterior root injury in patients with small skeletons.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究旨在探讨解剖学单束前交叉韧带(ACL)重建过程中外侧半月板前角根部损伤的发生及特点。

方法

2011 年至 2018 年间,70 例 ACL 损伤但无外侧半月板撕裂的女性患者接受了解剖学单束 ACL 重建。通过 CT 对预测的外侧半月板前角插入点与胫骨隧道的解剖关系进行回顾性评估,并将患者分为部分外侧半月板前角损伤组和完整组。比较两组患者的人口统计学特征、骨性标志之间的距离、胫骨隧道大小以及 MRI 评估的外侧半月板外突情况。

结果

70 例患者中有 13 例疑似部分外侧半月板前角损伤。损伤组患者身高明显低于完整组(157.7±6.4 比 161.4±5.4cm:p=0.03);损伤组从顶点到内侧髁间嵴斜坡底部的距离明显短于完整组(15.1±1.9 比 16.7±1.4mm:p=0.001)。

结论

在解剖学单束 ACL 重建中,18%的患者疑似存在部分外侧半月板前角损伤。损伤组患者身高和骨性标志之间的距离明显短于完整组。外科医生应认识到,即使胫骨隧道位置略有偏差,也可能导致小骨架患者发生部分外侧半月板前角损伤。

证据等级

IV。

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