Division of Joint Osteopathy and Traumatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China.
Division of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China.
BMC Musculoskelet Disord. 2022 May 12;23(1):445. doi: 10.1186/s12891-022-05406-6.
To determine the repair of LMPR lesions would improve the ACL graft maturation.
A total of 49 patients underwent ACL reconstruction were included in this study. Patients were furtherly sub-grouped according to the status of LMPR: intact (17), repair (16) and resected (16). Assessments performed pre- and 2 years post-operatively included patients-reported scores and arthrometer side-to-side difference. Magnetic resonance imaging was used 2 years after the surgery to compare the lateral meniscal extrusion (LME), anterior tibial subluxation of the medial compartment (ATSMC), anterior tibial subluxation of the lateral compartment (ATSLC), the difference of ATSMC and ATSLC, and signal/noise quotient (SNQ) of ACL graft.
In LMPR resected group, it showed greater post-operative ATSMC-ATSLC difference when compared with pre-operatively (P = 0.006) and with the other 2 groups (intact: P = 0.031; repair: P = 0.048). SNQ of ACL graft was higher in LMPR resected group than those in LMPR intact (P = 0.004) and repair group (P = 0.002). The LMPR repair group showed significant reduction in LME post-operatively (P = 0.001). Post-operative measures on ATSLC-ATSMC difference (β = 0.304, P = 0.049) and LME (β = 0.492, P = 0.003) showed significant association with graft SNQ.
Transtibial repair of LMPR concomitant with ACL reconstruction restored translational stability, reduced meniscus extrusion, making it beneficial for ACL graft maturation.
确定前交叉韧带(ACL)内移症(LMPR)病变的修复可以改善 ACL 移植物的成熟。
本研究共纳入 49 例行 ACL 重建的患者。根据 LMPR 的状态,患者进一步分为以下亚组:完整(17 例)、修复(16 例)和切除(16 例)。术前和术后 2 年分别进行评估,包括患者报告的评分和关节测径器的侧间差异。术后 2 年使用磁共振成像(MRI)比较外侧半月板挤出(LME)、内侧间室胫骨前移(ATSMC)、外侧间室胫骨前移(ATSLC)、ATSMC 和 ATSLC 的差异以及 ACL 移植物的信号/噪声比(SNQ)。
在 LMPR 切除组中,与术前(P = 0.006)和其他 2 组(完整:P = 0.031;修复:P = 0.048)相比,术后 ATSMC-ATSLC 差异更大。LMPR 切除组的 ACL 移植物 SNQ 高于 LMPR 完整组(P = 0.004)和修复组(P = 0.002)。LMPR 修复组术后 LME 显著减少(P = 0.001)。术后 ATSLC-ATSMC 差异(β = 0.304,P = 0.049)和 LME(β = 0.492,P = 0.003)的测量值与移植物 SNQ 呈显著相关性。
ACL 重建时经胫骨隧道修复 LMPR 恢复了平移稳定性,减少了半月板挤出,有利于 ACL 移植物的成熟。