Malinowski Konrad, Koźlak Magdalena, Mostowy Marcin, LaPrade Robert F, Ebisz Michał, Pękala Przemysław A
Artromedical Orthopedic Clinic, Belchatów, Poland.
Department of Anatomy, Jagiellonian University Medical College, International Evidence-Based Anatomy Working Group, Kraków, Poland.
Arthrosc Tech. 2022 May 11;11(6):e951-e957. doi: 10.1016/j.eats.2022.01.015. eCollection 2022 Jun.
One of the anatomic variations observable within the knee joint is a reduction in the posterior curvature of the femoral metaphysis proximal to the medial femoral condyle. This curvature is usually concave enough to fit the posterior horn of the medial meniscus (PHMM) during full knee flexion. A reduction in curvature may result in posteromedial tibiofemoral incongruence, a condition characterized by compression of the PHMM in full knee flexion, similar to cam incongruence in the hip joint. Clinical symptoms may occur in deep knee flexion, and progressive degeneration of the PHMM can be observed if this position is not prohibited. For patients in whom activity modification and conservative treatment have failed, surgery may be indicated. We describe arthroscopic treatment allowing for final intraoperative confirmation of the clinical indication for posteromedial tibiofemoral incongruence correction, as well as allowing for the least possible, yet sufficient, amount of correction.
膝关节内可观察到的解剖变异之一是股骨内侧髁近端干骺端后曲率减小。这种曲率通常足够凹陷，以便在膝关节完全屈曲时容纳内侧半月板后角（PHMM）。曲率减小可能导致胫股后内侧不匹配，这种情况的特征是膝关节完全屈曲时PHMM受压，类似于髋关节的凸轮不匹配。在深度屈膝时可能出现临床症状，如果不禁止该姿势，可观察到PHMM的进行性退变。对于活动调整和保守治疗失败的患者，可能需要手术治疗。我们描述了关节镜治疗，它可以在术中最终确认胫股后内侧不匹配矫正的临床指征，并允许进行尽可能少但足够的矫正。
