Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
Department of Orthopaedic Surgery, Chikamori Hospital, 1-1-16 Okawasuji, Kochi, 780-8522, Japan.
Knee Surg Sports Traumatol Arthrosc. 2021 Dec;29(12):4205-4212. doi: 10.1007/s00167-021-06505-y. Epub 2021 Mar 11.
The volume of medial meniscus (MM) extrusion at 10° and 90° knee flexions using three-dimensional (3D) magnetic resonance imaging (MRI) and assessed relevant clinical outcomes at 1-year follow-up were evaluated.
Twenty-four patients who underwent MM posterior root repair were retrospectively reviewed. At 10° and 90° knee flexions, the meniscal extrusion distance and volume were measured using 3D meniscus models constructed by SYNAPSE VINCENT®. The correlation between Knee Injury and Osteoarthritis Outcome Score, Lysholm, International Knee Documentation Committee scores, Tegner activity, and pain visual analog scales and changes in MM extrusion were assessed.
No significant differences in the MM medial extrusion were observed between 10° and 90° knee flexions postoperatively. MM posterior extrusion (MMPE) decreased significantly at 10° and 90° knee flexions postoperatively. At 90° knee flexion, the meniscus volume at the intra-tibial surface increased at 3 and 12 months postoperatively. The MM extrusion volume increased slightly at 10° knee flexion; however, the volume decreased significantly at 90° knee flexion postoperatively. The change in MMPE significantly correlated with clinical scores. All 12-month clinical scores were significantly improved compared to preoperative scores.
The progression of meniscus posterior extrusion and reduction of its volume at 90° knee flexion can be suppressed by MM posterior root repair. Postoperative clinical scores correlated with reductions of the posterior extrusion. Regarding clinical relevance, the dynamic stability of the meniscus can be maintained by MM posterior root repair, which is an effective therapeutic method for improving its clinical status.
Level IV.
使用三维（3D）磁共振成像（MRI）评估膝关节 10°和 90°屈曲时内侧半月板（MM）挤出的体积，并评估 1 年随访时相关的临床结果。
回顾性分析 24 例接受 MM 后根修复的患者。在 10°和 90°膝关节屈曲时，使用 SYNAPSE VINCENT®构建的 3D 半月板模型测量半月板挤出距离和体积。评估膝关节损伤和骨关节炎结果评分、Lysholm、国际膝关节文献委员会评分、Tegner 活动度和疼痛视觉模拟评分与 MM 挤出变化的相关性。
术后膝关节 10°和 90°屈曲时，MM 内侧挤出无显著差异。术后 MM 后挤出（MMPE）在 10°和 90°膝关节屈曲时显著减少。在 90°膝关节屈曲时，术后 3 个月和 12 个月胫骨内表面的半月板体积增加。在 10°膝关节屈曲时，MM 挤出体积略有增加；然而，术后 90°膝关节屈曲时体积显著减少。MMPE 的变化与临床评分显著相关。与术前评分相比，所有 12 个月的临床评分均显著改善。
MM 后根修复可抑制 90°膝关节屈曲时半月板后挤出和体积减少。术后临床评分与后挤出减少相关。就临床相关性而言，MM 后根修复可维持半月板的动态稳定性，是改善其临床状况的有效治疗方法。
IV 级。
