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利用磁共振成像评估与完全盘状外侧半月板相关的膝关节形态,作为骨骼成熟度的一个指标。

Evaluation of the knee joint morphology associated with a complete discoid lateral meniscus, as a function of skeletal maturity, using magnetic resonance imaging.

机构信息

Department of Orthopaedic Surgery, Osaka Metropolitan University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.

出版信息

Arch Orthop Trauma Surg. 2023 Apr;143(4):2095-2102. doi: 10.1007/s00402-022-04538-7. Epub 2022 Jul 15.

Abstract

INTRODUCTION

A discoid lateral meniscus (DLM) is associated with increased risk for meniscal tears and progression of knee joint osteoarthritis. Our aim was to differentiate knee joint morphology between patients with and without a DLM, as a function of skeletal maturity, using magnetic (MR) imaging.

MATERIALS AND METHODS

This was a retrospective analysis of MR images of the knee for 110 patients, 6-49 years of age. Of these, 62 were in the open physis group (38 with a DLM) and 48 in the closed physis group (23 with a DLM). The following morphological parameters were measured: anterior obliquity of the lateral tibial plateau (AOLTP), posterior obliquity of the lateral tibial plateau (POLTP), the lowest point of the lateral femoral condyle (LPLFC), and the posterior lateral condylar angle (PLCA).

RESULTS

Regardless of skeletal maturity, a DLM was associated with a greater inclination of the POLTP, lateralization of the LPLFC, and smaller PLCA (p < 0.001 for all compared to that of the control group). In the DLM group, the inclination of the AOLTP and the POLTP were significantly smaller (p < 0.001) and the LPLFC was more lateral (p < 0.001) in the closed physis group than in the open physis group. In the control group, the inclination of the POLTP was larger (p < 0.001) and the PLCA smaller (p = 0.019) in the open than in the closed physis group.

CONCLUSIONS

We identified a characteristic knee morphology among patients with a complete DLM using MR imaging, which was observed before physeal closure and persisted after skeletal maturity was attained. We also noted lateralization of the LPLFC in the presence of a DLM, with an increase in lateralization with skeletal maturation.

LEVEL OF EVIDENCE

Case-control study, III.

摘要

介绍

盘状外侧半月板(DLM)与半月板撕裂和膝关节骨关节炎进展的风险增加有关。我们的目的是使用磁共振成像(MR)区分有和没有 DLM 的患者的膝关节形态,作为骨骼成熟度的函数。

材料和方法

这是对 110 名 6-49 岁患者膝关节的 MR 图像进行的回顾性分析。其中 62 例在骺板开放组(38 例有 DLM),48 例在骺板闭合组(23 例有 DLM)。测量了以下形态参数:外侧胫骨平台前倾斜角(AOLTP)、外侧胫骨平台后倾斜角(POLTP)、外侧股骨髁最低点(LPLFC)和外侧后髁角(PLCA)。

结果

无论骨骼成熟度如何,DLM 与 POLTP 的更大倾斜度、LPLFC 的外侧化和更小的 PLCA 相关(与对照组相比,所有参数均为 p < 0.001)。在 DLM 组中,与骺板开放组相比,骺板闭合组的 AOLTP 和 POLTP 的倾斜度明显更小(p < 0.001),LPLFC 更外侧(p < 0.001)。在对照组中,与骺板闭合组相比,骺板开放组的 POLTP 倾斜度更大(p < 0.001),PLCA 更小(p = 0.019)。

结论

我们使用 MR 成像在完全 DLM 患者中识别出一种特征性的膝关节形态,这种形态在骺板闭合之前就存在,并在骨骼成熟后持续存在。我们还注意到 DLM 存在时 LPLFC 的外侧化,并且随着骨骼成熟度的增加而增加外侧化。

证据水平

病例对照研究,III 级。

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