Sports Clinic, Centre Hospitalier de Luxembourg-Clinique d'Eich, 78, rue d' Eich, 1460, Luxembourg, Luxembourg.
Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science, Luxembourg, Luxembourg.
Knee Surg Sports Traumatol Arthrosc. 2021 Sep;29(9):3059-3067. doi: 10.1007/s00167-020-06352-3. Epub 2020 Nov 9.
The purpose of this study was (1) to describe the meniscus tear pattern in anterior cruciate ligament (ACL)-injured patients, with a special focus on medial meniscus (MM) ramp lesions and lateral meniscus (LM) root tears and (2) to determine whether patient and injury characteristics were associated with meniscus tear patterns.
Data from 358 cases of ACL primary and revision reconstruction surgeries were extracted from a center-based registry. During arthroscopy, the presence of associated meniscus lesions was documented by systematically inspecting the anterior and posterior tibiofemoral compartments. With a special focus on MM ramp lesions and LM root tears, groups of different injury tear patterns were formed. Chi-square tests were used to determine whether these groups differed with respect to various patient and injury characteristics, including gender, previous ipsilateral ACL injuries, the injury's relation to sport, person contact during injury and the type of ACL tear. Median age at surgery and body mass index were compared between groups using the Kruskal-Wallis test. Significance was set at p < 0.05.
Two hundred and thirty-nine ACL injuries (67%) showed additional meniscal injuries, of which 125 (52%) involved the MM ramp and/or the LM root. Ramp lesions were more frequent in males (23% vs 12% in females, p < 0.01), in contact injuries (28% vs 16% in non-contact, p < 0.05) and in complete ACL tears (21% vs 5% in partial, p < 0.05). Combined injuries of the MM ramp and the LM root showed a higher percentage of contact injuries compared to non-contact injuries (10% vs 4%, p < 0.05).
Two-thirds of all ACL injuries showed a concomitant meniscus injury, of which half involved the biomechanically relevant, but previously often undiagnosed RLMM or the PRLM. These findings provide evidence that until recently about half of ACL-associated meniscus injuries were not properly identified. Ramp lesions were more frequent in males, contact injuries and in complete ACL tears. These findings stress the need for a systematic assessment and a better understanding of the pathomechanism of these specific injuries which may have an important impact on knee biomechanics and the outcome of ACL reconstruction.
III.
本研究的目的是：(1) 描述前交叉韧带（ACL）损伤患者的半月板撕裂模式，特别关注内侧半月板（MM）后角撕裂和外侧半月板（LM）根部撕裂；(2) 确定患者和损伤特征是否与半月板撕裂模式相关。
从一个中心注册处提取了 358 例 ACL 初次和翻修重建手术的数据。在关节镜检查过程中，通过系统检查前、后胫骨间室来记录伴发的半月板损伤。特别关注 MM 后角撕裂和 LM 根部撕裂，形成不同的损伤撕裂模式组。采用卡方检验确定这些组在性别、同侧 ACL 既往损伤、损伤与运动的关系、受伤时是否有人体接触以及 ACL 撕裂类型等各种患者和损伤特征方面是否存在差异。使用 Kruskal-Wallis 检验比较组间的手术时中位年龄和体重指数。以 p<0.05 为差异有统计学意义。
239 例 ACL 损伤（67%）伴发半月板损伤，其中 125 例（52%）涉及 MM 后角和/或 LM 根部。男性的后角撕裂发生率较高（23%比女性的 12%，p<0.01），接触性损伤发生率较高（28%比非接触性损伤的 16%，p<0.05），完全 ACL 撕裂的发生率较高（21%比部分 ACL 撕裂的 5%，p<0.05）。与非接触性损伤相比，MM 后角和 LM 根部联合损伤的接触性损伤比例更高（10%比 4%，p<0.05）。
三分之二的 ACL 损伤伴发半月板损伤，其中一半涉及生物力学上重要但以前常未被诊断的 RLMM 或 PRLM。这些发现表明，直到最近，大约一半的 ACL 相关半月板损伤都没有被正确识别。后角撕裂在男性、接触性损伤和完全 ACL 撕裂中更为常见。这些发现强调了需要对这些特定损伤进行系统评估和更好地理解其发病机制的必要性，这可能对膝关节生物力学和 ACL 重建的结果有重要影响。
III 级。
