Hisashi Kosuke, Muneta Takeshi, Kohno Yuji, Sasaki Mana, Yamazaki Junya, Hayashi Haruhisa, Koga Hideyuki, Morito Toshiyuki
Hachioji-Higashi Orthopedic Clinic and Akishima Orthopedic Clinic, Joint Surgery Institute, 36-1 Takakura-machi, Hachioji-shi, Tokyo, 192-0033, Japan.
Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
J Exp Orthop. 2022 Apr 29;9(1):38. doi: 10.1186/s40634-022-00474-y.
The purpose of this study was to compare the medial meniscus (MM) degeneration, meniscus extrusion, and tibial joint inclination by using MRI to consider the pathogenesis of posterior root tear (PRT) in medial-type knee osteoarthritis (KOA) both with and without medial meniscus posterior root tear (MMPRT).
This study used open MRI with flexion sagittal view and included 324 medial-type osteoarthritic knees with a Kellegren-Lawrence grade of 2 or less. Following the exclusion process, 151 knees were selected for MRI analysis. MM degeneration grading was performed according to Jerosch by 5 degrees of 0-4 in four different portions from anterior to posterior. MM medial extrusion (MMME), MM posterior extrusion (MMPE), medial tibial medial slope (MTMS), and medial tibial posterior slope (MTPS) were measured according to previous studies.
MM degeneration in the anterior portion to MCL averaged 1.72 ± 0.67 in the PRT group (n = 48) and 1.40 ± 0.78 in the non-PRT group (n = 103). The degeneration grade was statistically higher in the PRT group than in the non-PRT group (p = 0.050). There was no difference in MM degeneration in the other three portions. MMME averaged 4.02 ± 1.12 mm in the PRT group and 3.11 ± 1.11 mm in the non-PRT group. MMPE averaged 4.22 ± 0.87 mm in the PRT group and 2.83 ± 1.12 mm in the non-PRT group. Both MMME and MMPE in the PRT group were statistically larger than those in the non-PRT group (p < 0.001). There was no difference in MTMS between the two groups. MTPS averaged 6.34 ± 2.25° in the PRT group and 5.28 ± 2.23° in the non-PRT group. The MTPS of the PRT group was statistically larger than that of the non-PRT group (p = 0.007).
The severity of MM degeneration, extrusion of MM, and degree of tibial slope were compared between medial-type KOA with and without PRT using an open MRI. MM degeneration was more severe anteriorly in the PRT group. The PRT group showed larger MMME and MMPE with greater MTPS.
III. Retrospective cohort study.
本研究旨在通过磁共振成像（MRI）比较内侧半月板（MM）退变、半月板挤出及胫骨关节倾斜情况，以探讨内侧型膝关节骨关节炎（KOA）伴或不伴内侧半月板后根撕裂（MMPRT）时后根撕裂（PRT）的发病机制。
本研究采用开放式MRI的屈曲矢状位视图，纳入324例Kellegren-Lawrence分级为2级及以下的内侧型骨关节炎膝关节。经过排除过程，选取151例膝关节进行MRI分析。MM退变分级根据Jerosch方法，从前往后在四个不同部分按0 - 4度分为5级。根据既往研究测量MM内侧挤出（MMME）、MM后侧挤出（MMPE）、胫骨内侧坡度（MTMS）和胫骨后侧坡度（MTPS）。
PRT组（n = 48）中MM前部至内侧副韧带（MCL）的退变平均为1.72±0.67，非PRT组（n = 103）为1.40±0.78。PRT组的退变分级在统计学上高于非PRT组（p = 0.050）。其他三个部分的MM退变无差异。PRT组MMME平均为4.02±1.12 mm，非PRT组为3.11±1.11 mm。PRT组MMPE平均为4.22±0.87 mm，非PRT组为2.83±1.12 mm。PRT组的MMME和MMPE在统计学上均大于非PRT组（p < 0.001）。两组之间MTMS无差异。PRT组MTPS平均为6.34±2.25°，非PRT组为5.28±2.23°。PRT组的MTPS在统计学上大于非PRT组（p = 0.007）。
使用开放式MRI比较了伴或不伴PRT的内侧型KOA中MM退变的严重程度、MM挤出情况及胫骨坡度。PRT组MM前部退变更严重。PRT组显示出更大的MMME和MMPE以及更大的MTPS。
III。回顾性队列研究。
