评估具有超大后角的不完全盘状内侧半月板的形态特征。
Evaluation of morphological characteristics for incomplete discoid medial meniscus with an oversized posterior segment.
机构信息
Department of Orthopaedic Surgery, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-chou Hirohata-ku, Himeji-City, Hyogo, 671-1122, Japan.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
J Orthop Surg Res. 2022 Apr 20;17(1):245. doi: 10.1186/s13018-022-03132-2.
BACKGROUND
A discoid medial meniscus is rare in comparison with a discoid lateral meniscus. We encountered a new type of incomplete discoid with an oversized posterior segment. Therefore, this study aimed to report cases of medial meniscus with an oversized posterior segment and analyze the morphological characteristics by comparing them to cases with a discoid medial meniscus and normal medial meniscus.
METHODS
Four patients with an oversized posterior segment medial meniscus (oversize group, mean age: 25.3 ± 12.0 years) and seven patients with a discoid medial meniscus (discoid group, mean age: 34.4 ± 19.6) were identified using magnetic resonance imaging (MRI) and diagnosed by arthroscopic findings in our hospital. Fifty patients without medial meniscal injury were retrospectively selected as the normal group (normal group, mean age: 24.0 ± 11.3 years). The clinical symptoms were examined. The anteroposterior (AP) length of both the anterior and posterior segments, AP length ratio of the posterior segment to the AP length of the medial tibial plateau, and mediolateral (ML) width of the mid-body of the medial meniscus were also evaluated using MRI and compared among the three groups.
RESULTS
All patients in the oversize group complained of medial knee pain during deep knee flexion. In sagittal MRI, posteriorly deviated indentations were also observed at the medial tibial plateau in all cases in the oversize group. There was a significant difference in the AP length of the posterior segment between the normal and oversize groups (14.3 ± 2.8 vs. 23.6 ± 2.8 mm, P < 0.001), whereas there was no significant difference in the AP length of the anterior segment (9.1 ± 2.1 vs. 9.5 ± 1.9 mm, P = 0.869). The ML width of the mid-body in the normal, oversize, and discoid groups was 9.3 ± 1.8, 19.9 ± 2.6, and 25.8 ± 1.9 mm, respectively (normal vs. oversize group: P < 0.001, oversize vs discoid group: P = 0.01, normal vs. discoid group: P < 0.001).
CONCLUSIONS
Oversized posterior and normal anterior segments characterize this new type of incomplete discoid medial meniscus as a morphological abnormality.
背景
与外侧盘状半月板相比，内侧盘状半月板较为少见。我们遇到了一种新的内侧半月板后角过大的不完全盘状半月板。因此，本研究旨在报告内侧半月板后角过大的病例，并通过与内侧盘状半月板和正常内侧半月板病例进行比较，分析其形态特征。
方法
通过磁共振成像（MRI）在我院发现并经关节镜确诊，4 例内侧半月板后角过大（过大组，平均年龄：25.3±12.0 岁）和 7 例内侧盘状半月板（盘状组，平均年龄：34.4±19.6 岁）患者。回顾性选择 50 例无内侧半月板损伤的患者作为正常组（正常组，平均年龄：24.0±11.3 岁）。检查临床症状。使用 MRI 评估内侧半月板前、后段的前后向（AP）长度、后段 AP 长度与内侧胫骨平台 AP 长度的比值以及内侧半月板体部的中-外侧（ML）宽度，并比较三组间的差异。
结果
过大组所有患者在膝关节深度弯曲时均诉膝关节内侧疼痛。在矢状位 MRI 上，过大组所有患者的内侧胫骨平台也可见向后偏移的凹陷。正常组与过大组的后段 AP 长度有显著差异（14.3±2.8 vs. 23.6±2.8mm，P<0.001），而前段 AP 长度无显著差异（9.1±2.1 vs. 9.5±1.9mm，P=0.869）。正常组、过大组和盘状组的内侧半月板体部的 ML 宽度分别为 9.3±1.8、19.9±2.6 和 25.8±1.9mm（正常组与过大组：P<0.001，过大组与盘状组：P=0.01，正常组与盘状组：P<0.001）。
结论
过大的后角和正常的前角是这种新型内侧半月板不完全盘状的形态学异常特征。
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