University of Rome Foro Italico, Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, Rome, Italy.
Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, Rome, Italy.
Orthop Traumatol Surg Res. 2022 May;108(3):103226. doi: 10.1016/j.otsr.2022.103226. Epub 2022 Feb 2.
Medial meniscal extrusion (ME) has been found to be associated to anterior cruciate ligament (ACL) injury. Post-traumatic extrusion is mainly attributed to meniscotibial ligament (MTL) tear. The aim of this retrospective study was to assess the incidence of MTL tear associated with meniscal extrusion, evaluate arthroscopic findings and the associated clinical findings.
The medial meniscal extrusion, when associated to ACL injury, is related to a tear of the MTL.
Patients who underwent to primary or revision ACL reconstruction with associated medial meniscal rise and/or meniscotibial tear or insufficiency were retrospectively identified over a 5-year period (from 2015 to 2019). Twenty-four patients were included in this study with preoperative magnetic resonance imaging (MRI) carried out at our institution Each MRI was evaluated by the senior author for the presence of meniscal extrusion and also for the additional pathology of meniscotibial ligament. Patient medical records were reviewed to obtain demographic information, including age, gender, and arthrometric evaluation of anteroposterior laxity.
All included patients underwent arthroscopic ACL reconstruction using autograft tissue, (19 primary and in 5 revision ACL reconstruction). The mean age was 31.2 years (range: 15-57; SD: 12.3 years) at the time of surgery. ME was identified at MRI in all cases preoperatively and confirmed arthroscopically. No correlation was found between meniscal extrusion and anteroposterior translation (ρ=-0.270; p=0.202). Neither between having more than 3mm of extrusion and gender (χ=0.80; p=0.371), acute/chronic lesion (χ=0.91; p=0.341) and primary/revision reconstructions (χ=0.83; p=0.364). In the last three patients, arthroscopic treatment of meniscal extrusion was carried out through outside-in repair of medial meniscus at its capsular junction. Reduction of meniscal extrusion has been verified by MRI, performed at 3-month follow-up.
A high prevalence of ME was found at MRI in patients with ACL injury and MTL tear. Therefore, ME may be associated to acute or chronic ligamentous injury involving the MTL, and its tear can be considered as the main determinant of extrusion. Further research is needed to increase evidence concerning MTL incidence and surgical outcomes.
IV, retrospective case series.
内侧半月板挤压（ME）与前交叉韧带（ACL）损伤有关。创伤后挤压主要归因于半月板胫骨韧带（MTL）撕裂。本回顾性研究的目的是评估与半月板挤压相关的 MTL 撕裂的发生率，评估关节镜检查结果和相关的临床发现。
内侧半月板挤压，当与 ACL 损伤相关时，与 MTL 撕裂有关。
在 5 年期间（2015 年至 2019 年），回顾性地确定了在我院接受初次或再次 ACL 重建且伴有内侧半月板升高和/或半月板胫骨撕裂或不全的患者。本研究共纳入 24 例患者，均在我院进行术前磁共振成像（MRI）检查。高级作者评估了每位患者的 MRI，以评估半月板挤压的存在以及半月板胫骨韧带的其他病变。查阅患者病历以获取人口统计学信息，包括年龄、性别和前-后松弛的关节测量评估。
所有纳入的患者均采用自体移植物组织进行关节镜下 ACL 重建（19 例初次和 5 例再次 ACL 重建）。手术时的平均年龄为 31.2 岁（范围：15-57；标准差：12.3 岁）。所有病例术前均在 MRI 上发现 ME，并经关节镜证实。半月板挤压与前-后平移之间无相关性（ρ=-0.270；p=0.202）。挤压超过 3mm 与性别（χ=0.80；p=0.371）、急性/慢性病变（χ=0.91；p=0.341）和初次/再次重建（χ=0.83；p=0.364）之间均无相关性。在最后 3 例患者中，通过在半月板囊交界处进行内侧半月板的经皮修复，对半月板挤压进行了关节镜治疗。在 3 个月的随访时，通过 MRI 证实了半月板挤压的减少。
在 ACL 损伤和 MTL 撕裂的患者中，MRI 发现 ME 的患病率较高。因此，ME 可能与涉及 MTL 的急性或慢性韧带损伤有关，其撕裂可被视为挤压的主要决定因素。需要进一步的研究来增加关于 MTL 发生率和手术结果的证据。
IV，回顾性病例系列。
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