Choi Nam-Hong, Hwangbo Byung-Hun, Kang Hang-Ki, Yang Bong-Seok, Victoroff Brian N
Department of Orthopaedic Surgery, Eulji Medical Center, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, Shihwa Medical Center, Siheung, Republic of Korea.
Orthop J Sports Med. 2022 May 12;10(5):23259671221089250. doi: 10.1177/23259671221089250. eCollection 2022 May.
Anatomic placement of the meniscal allograft is imperative to achieve satisfactory outcomes after meniscal allograft transplantation (MAT). Few studies have reported on the accuracy of the provisional location of the center of the anterior horn of the lateral meniscus (AHLM).
The authors hypothesized that the provisional center would not coincide with the anatomic center of the AHLM.
Descriptive laboratory study.
Tibial plateaus were retrieved from 93 consecutive patients who underwent total knee arthroplasty. A complete radial cut was made 2 cm lateral to the insertion of the AHLM on the retrieved tibial plateau. While moving the stump of the anterior horn with forceps, the center of the insertion was determined, and a Kirschner wire (provisional wire) was drilled into the location. The insertion area of the AHLM was dissected carefully, and the periphery of the insertion area of the anterior horn was marked. Another Kirschner wire (anatomic wire) was drilled into the center of the dissected anterior horn. The resected tibial plateau was positioned so that the longitudinal line of the tibial plateau was aligned on a plastic ruler. The distance between the provisional and anatomic wires was measured by a digital caliper along the longitudinal and vertical axes.
The mean distance between the provisional and anatomic wires was 2.5 ± 1.2 mm. The provisional wire in 14 patients (15%) was placed at the anatomic center. In 36 patients (39%), the provisional wire was drilled anterolateral to the anatomic center, and in 18 patients (19%), the wire was drilled anteromedial to the anatomic center. In 21 patients (23%), the provisional wire was located within 2 mm of the anatomic center, and in 62 patients (67%), the wire was located within 3 mm of the anatomic center.
The provisional wire was located a mean of 2.5 mm from the anatomic center, and only 23% of patients had wires that were located within 2 mm of the anatomic center. In 39% of patients, the provisional wire was drilled anterolateral to the anatomic center. This finding needs to be considered during lateral MAT.
Without dissection of the AHLM, the determination of the anatomic center of the anterior horn is not accurate during lateral MAT.
半月板同种异体移植（MAT）术后要获得满意疗效，半月板同种异体移植物的解剖学放置至关重要。很少有研究报道外侧半月板前角（AHLM）临时定位中心的准确性。
作者假设临时中心与AHLM的解剖学中心不一致。
描述性实验室研究。
从93例连续接受全膝关节置换术的患者中获取胫骨平台。在获取的胫骨平台上，于AHLM附着点外侧2 cm处进行完整的径向切割。用镊子移动前角残端时，确定附着点中心，并钻入一根克氏针（临时针）至该位置。仔细解剖AHLM的附着区域，并标记前角附着区域的周边。在解剖后的前角中心钻入另一根克氏针（解剖针）。将切除的胫骨平台放置好，使胫骨平台的纵线与塑料尺对齐。用数字卡尺沿纵轴和垂直轴测量临时针与解剖针之间的距离。
临时针与解剖针之间的平均距离为2.5±1.2 mm。14例患者（15%）的临时针位于解剖学中心。36例患者（39%）的临时针钻在解剖学中心的前外侧，18例患者（19%）的临时针钻在解剖学中心的前内侧。21例患者（23%）的临时针位于距解剖学中心2 mm范围内，62例患者（67%）的临时针位于距解剖学中心3 mm范围内。
临时针距解剖学中心平均为2.5 mm，只有23%的患者的针位于距解剖学中心2 mm范围内。39%的患者的临时针钻在解剖学中心的前外侧。在外侧MAT过程中需要考虑这一发现。
在外侧MAT过程中，如果不解剖AHLM，前角解剖学中心的确定不准确。
