Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
J Orthop Sci. 2021 Mar;26(2):237-242. doi: 10.1016/j.jos.2020.03.012. Epub 2020 Apr 10.
Medial meniscus (MM) posterior root repairs show favorable clinical outcomes in patients with MM posterior root tears (MMPRTs). However, there is no useful magnetic resonance imaging (MRI) finding to determine a functionally good meniscal healing following MM posterior root repairs. We hypothesized that a characteristic postoperative MRI finding can predict a good meniscal healing following pullout repairs. The aim of this study was to investigate a clinical usefulness of several MRI findings for estimating an actual meniscal healing following MMPRT repairs.
Fifty eight patients who had a posteromedial painful popping of the injured knee and underwent an arthroscopic pullout repair for the MMPRT were included. Arthroscopic meniscal healing was assessed according to the Furumatsu scoring system at 1 year postoperatively. We evaluated postoperative MRI-based meniscal healing using signal intensity, continuity, suspension bridge-like sign of the MM posterior root, and MM medial extrusion on coronal images. Postoperative clinical outcome evaluations were performed at second-look arthroscopy.
Twenty three patients showed good arthroscopic healing scores (≥7 points). Thirty five patients had moderate/poor arthroscopic healing scores (<7 points). At 1-year follow-up period, clinical outcome scores were significantly higher in the good healing group than in the moderate/poor healing group. A characteristic meniscal shape, termed "suspension bridge sign", was highly observed in the good meniscal healing group (83%) compared with in the moderate/poor healing group (26%, P < 0.001). High signal intensity and continuity of the MM posterior root and MM medial extrusion showed no differences between both groups.
Our study demonstrated that the MRI-based suspension bridge sign can predict an arthroscopically favorable meniscal healing following the MM posterior root repair. The suspension bridge-like MRI finding of the MM would be a useful indicator to evaluate the actual meniscal healing in patients who underwent pullout repairs for MMPRTs.
半月板后根（MM）撕裂（MMPRT）患者的 MM 后根修复显示出良好的临床结果。然而，目前还没有有用的磁共振成像（MRI）发现来确定 MM 后根修复后半月板功能良好的愈合。我们假设，一种特征性的术后 MRI 发现可以预测 MM 后根修复后半月板良好的愈合。本研究旨在探讨几种 MRI 发现对估计 MMPRT 修复后实际半月板愈合的临床应用价值。
纳入 58 例膝关节后内侧疼痛弹响且接受关节镜下 MM 后根撕裂的关节镜下抽出修复术的患者。术后 1 年根据 Furumatsu 评分系统评估半月板愈合情况。我们在冠状图像上评估基于 MRI 的 MM 后根信号强度、连续性、半月板后根悬索桥样征和 MM 内侧外突的半月板愈合情况。在二次关节镜检查时进行术后临床结果评估。
23 例患者的关节镜愈合评分良好（≥7 分）。35 例患者的关节镜愈合评分中等/差（<7 分）。在 1 年随访期间，良好愈合组的临床结果评分明显高于中等/差愈合组。在良好半月板愈合组（83%）中，半月板的特征性形状（称为“悬索桥样征”）比在中等/差愈合组（26%，P<0.001）中更常见。MM 后根高信号强度和连续性以及 MM 内侧外突在两组之间无差异。
我们的研究表明，基于 MRI 的悬索桥样征可以预测 MM 后根修复后关节镜下半月板愈合良好。MM 的悬索桥样 MRI 发现可能是评估 MMPRT 抽出修复术后实际半月板愈合的有用指标。
