Department of Orthopaedic Surgery, Okayama University Graduate School, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan.
Division of Radiology, Medical Technology Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan.
Knee Surg Sports Traumatol Arthrosc. 2020 Nov;28(11):3435-3442. doi: 10.1007/s00167-020-05953-2. Epub 2020 Apr 6.
Transtibial repair of a medial meniscus posterior root tear (MMPRT) can improve clinical outcomes, although meniscal extrusion remains. However, few studies have investigated the volume of meniscal extrusion. This study aimed to evaluate the effect of transtibial repair in reducing the volume using three-dimensional (3D) magnetic resonance imaging, at 10° and 90° knee flexion.
Twenty patients with MMPRTs and 16 volunteers with normal knees participated. The 3D models of meniscus were constructed using SYNAPSE VINCENT. The meniscal extrusion and its volume were measured at 10° and 90° knee flexion. Differences between the pre- and postoperative examinations were assessed using the Wilcoxon signed-rank test. The postoperative parameters were compared to those in patients with normal knees.
There were no significant pre- and postoperative differences in any parameter at 10° knee flexion. At 90° knee flexion, the posterior extrusion and its meniscal volume were decreased significantly after transtibial repair (p < 0.05), even though these parameters were larger than in the normal knees. On the other hand, intra-articular meniscal volume calculated by the extrusion volume was increased to the level of the normal knee.
This study demonstrated that transtibial repairs improved the intra-articular/intra-tibial surface volume of the medial meniscus by reducing the posteromedial extrusion during knee flexion. This 3D analysis is clinically relevant in evaluating that, while transtibial root repair has a limited ability to reduce meniscal extrusion, it can restore the functional volume of the medial meniscus which contributes to the shock absorber postoperatively.
IV.
经胫骨修复内侧半月板后根部撕裂（MMPRT）可以改善临床结果，尽管仍存在半月板挤出。然而，很少有研究调查半月板挤出的体积。本研究旨在使用三维（3D）磁共振成像评估经胫骨修复在 10°和 90°膝关节屈曲时减少体积的效果。
20 例 MMPRT 患者和 16 例正常膝关节志愿者参与了本研究。使用 SYNAPSE VINCENT 构建半月板的 3D 模型。在 10°和 90°膝关节屈曲时测量半月板挤出及其体积。使用 Wilcoxon 符号秩检验评估术前和术后检查之间的差异。将术后参数与正常膝关节患者进行比较。
在 10°膝关节屈曲时，任何参数均无明显的术前和术后差异。在 90°膝关节屈曲时，经胫骨修复后后外侧挤出及其半月板体积明显减少（p<0.05），尽管这些参数大于正常膝关节。另一方面，通过挤出体积计算的关节内半月板体积增加到正常膝关节的水平。
本研究表明，经胫骨修复通过减少膝关节屈曲时的后内侧挤出，改善了内侧半月板的关节内/关节内表面体积。这种 3D 分析在评估经胫骨根修复虽然有一定能力减少半月板挤出，但可以恢复内侧半月板的功能体积方面具有临床相关性，这有助于术后的减震器功能。
IV。
