内侧半月板后角撕裂与胫骨后倾增加有关：病例对照研究。
Medial Meniscal Posterior Horn Tears Are Associated With Increased Posterior Tibial Slope: A Case-Control Study.
机构信息
Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
出版信息
Am J Sports Med. 2020 Jun;48(7):1702-1710. doi: 10.1177/0363546520917420. Epub 2020 May 14.
BACKGROUND
While the medial meniscal posterior horn (MMPH) is reported to bear a considerable portion of overall load on the knee joint, including compressive and shear forces, no study has yet investigated the relationship between the MMPH and posterior tibial slope (PTS), which is a geometric factor associated with the shear force component in the presence of a compressive load in the knee joint.
HYPOTHESIS/PURPOSE: The purpose was to investigate the relationship between the PTS and MMPH tears in patients without ligamentous injury. It was hypothesized that the PTS is greater in patients with MMPH tears as compared with those without.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
From March 2015 to December 2018, 159 patients with isolated MMPH tears and 60 patients without any pathologic findings on magnetic resonance imaging (control group) were included in this study. The PTS in the affected and contralateral knees was compared between the groups, which were statistically matched according to baseline characteristics (ie, age, sex, body mass index, radiographic osteoarthritis grade according to the Kellgren-Lawrence scale, and hip-knee-ankle angle) via the inverse probability of treatment weighting method. Furthermore, the MMPH tear group was subdivided according to meniscal tear patterns; these subgroups were then compared with the control group.
RESULTS
The mean PTS was significantly greater in the MMPH tear group than in the control group (affected knee: MMPH tear group, 7.0°± 3.4° [mean ± SD]; control group, 5.2°± 2.1°, .001; contralateral knee: MMPH tear group, 6.7°± 3.3°; control group, 4.7°± 2.2°, .001). The mean PTS in each subgroup also tended to be greater than that in the control group. In the receiver operating characteristic curve analysis, the cutoff point of the PTS discriminating between the MMPH tear and control groups was 6.6° for the affected knee (sensitivity, 55.3%; specificity, 75.0%) and 5.5° for the contralateral knee (sensitivity, 61.0%; specificity, 76.7%).
CONCLUSION
An increased PTS is strongly associated with an increased incidence of MMPH tears and less affected by the meniscal tear patterns.
背景
虽然内侧半月板后角（MMPH）被认为在膝关节中承受相当一部分的整体负荷，包括压缩力和剪切力，但尚无研究调查 MMPH 与后胫骨斜率（PTS）之间的关系，后者是与膝关节中存在压缩负荷时的剪切力分量相关的几何因素。
假设/目的：本研究旨在调查无韧带损伤患者中 PTS 与 MMPH 撕裂之间的关系。假设与无 MMPH 撕裂的患者相比，患有 MMPH 撕裂的患者 PTS 更大。
研究设计
队列研究；证据水平，3 级。
方法
本研究纳入了 2015 年 3 月至 2018 年 12 月期间 159 例单纯 MMPH 撕裂患者和 60 例磁共振成像（MRI）无任何病理发现的患者（对照组）。通过逆概率处理权重法，根据基线特征（即年龄、性别、体重指数、根据 Kellgren-Lawrence 量表的放射学骨关节炎分级以及髋膝踝角）对两组患者进行统计学匹配，比较两组患者患侧和对侧膝关节的 PTS。此外，根据半月板撕裂模式将 MMPH 撕裂组进一步细分，然后与对照组进行比较。
结果
MMPH 撕裂组的平均 PTS 明显大于对照组（患侧膝：MMPH 撕裂组为 7.0°±3.4°[平均值±标准差]；对照组为 5.2°±2.1°，.001；对侧膝：MMPH 撕裂组为 6.7°±3.3°；对照组为 4.7°±2.2°，.001）。每个亚组的平均 PTS 也倾向于大于对照组。在受试者工作特征曲线分析中，区分 MMPH 撕裂与对照组的 PTS 截断值为患侧膝 6.6°（敏感性，55.3%；特异性，75.0%）和对侧膝 5.5°（敏感性，61.0%；特异性，76.7%）。
结论
PTS 增加与 MMPH 撕裂发生率增加密切相关，且较少受半月板撕裂模式的影响。
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