Lee Jae Ik, Kim Dong Hyun, Choi Han Gyeol, Kim Tae Woo, Lee Yong Seuk
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Korea.
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul 07061, Korea.
J Clin Med. 2021 Feb 3;10(4):557. doi: 10.3390/jcm10040557.
Meniscal tear is a common reason for patients to undergo knee operation, and the medial meniscus posterior root tear (MMPRT) is one of the most frequent kinds of meniscal tears. The purpose of this study was to analyze participants' factors (anthropometric and medical) to the fate of the MMPRT based on the treatment strategy. The hypothesis of this study was that treatment modalities from conservative treatment to final arthroplasty would be affected by participants' affecting factors. From July 2003 to May 2018, 640 participants were included. Groups were categorized according to the treatment strategies such as conservative treatment, arthroscopic surgery, high tibial osteotomy (HTO) and arthroplasty surgery. Participants' affecting factors were analyzed by one-way analysis of variance according to the four different treatment strategies and a correlation between affecting factors was also analyzed. Participants with K-L (Kellgren-Lawrence) Grade 4 and high BMI > 28.17 were appropriate candidates for arthroplasty, with K-L Grade 4 being a greater determining factor than high BMI. Participants with alignment factors such as low initial weight bearing line (WBL) (26.5%) and high delta WBL ratio (5.9%) were appropriate candidates for HTO, with the delta WBL ratio being a greater determining factor than initial WBL. Longer MRI-event times (1.44 year) and a lesser extent of meniscal extrusion (2.98 mm) were significantly associated with conservative treatment. Understanding the correlation of each affecting factor to the treatment strategy will help clinicians decide on the appropriate treatment for patients with MMPRT.
半月板撕裂是患者接受膝关节手术的常见原因,而内侧半月板后根撕裂(MMPRT)是最常见的半月板撕裂类型之一。本研究的目的是基于治疗策略分析参与者的因素(人体测量学和医学因素)对MMPRT预后的影响。本研究的假设是,从保守治疗到最终关节置换术的治疗方式会受到参与者影响因素的影响。2003年7月至2018年5月,纳入了640名参与者。根据保守治疗、关节镜手术、高位胫骨截骨术(HTO)和关节置换手术等治疗策略对分组。根据四种不同的治疗策略,通过单因素方差分析分析参与者的影响因素,并分析影响因素之间的相关性。K-L(Kellgren-Lawrence)分级为4级且BMI>28.17的参与者是关节置换术的合适人选,其中K-L分级4级比高BMI是更重要的决定因素。具有低初始负重线(WBL)(26.5%)和高WBL变化率(5.9%)等对线因素的参与者是HTO的合适人选,其中WBL变化率比初始WBL是更重要的决定因素。较长的MRI检查时间间隔(1.44年)和较小的半月板挤压程度(2.98毫米)与保守治疗显著相关。了解每个影响因素与治疗策略的相关性将有助于临床医生为MMPRT患者决定合适的治疗方案。