Konya Şehir Hastanesi Ortopedi ve Travmatoloji Kliniği, 42020 Karatay, Konya, Türkiye.
Jt Dis Relat Surg. 2022;33(2):399-405. doi: 10.52312/jdrs.2022.653. Epub 2022 Jul 6.
This study aimed to define the medial meniscus posterior base angle (MMPBA) and the lateral meniscus posterior base angle (LMPBA) measured in the medial and lateral meniscus posterior horns and examine the biomechanical and morphological relationship between anterior cruciate ligament (ACL) injuries and posterior meniscus horns using these parameters.
The retrospective study was conducted with 32 patients with ACL rupture and 40 control patients, for a total of 72 patients (40 males, 32 females; mean age: 36.3±9.9 years; range, 18 to 57 years), between January 2016 and January 2018. The posterior tibial slope (PTS) was measured in standard radiographs, and MMPBA and LMPBA values were assessed by standard knee magnetic resonance imaging. The MMPBA was defined as the angle between the line passing through the medial meniscus' tibial side border and the line passing through the capsular side border in the sagittal section's medial meniscus posterior horn. The LMPBA was defined as the angle between the line passing through the lateral meniscus' tibial side border and the line passing through the capsular side border on the sagittal section's lateral meniscus posterior horn. Groups were compared for PTS, MMPBA, and LMPBA.
When both groups were compared in terms of MMPBA and LMPBA, patients with ACL rupture had significantly higher base angles (p<0.001 and p=0.031, respectively). The mean MMPBA was 84.27º±12.59º (range, 62º to 106.1º) in patients with ACL rupture, while it was 70.75º±7.85º (range, 55.1º to 88.6º) in the control group. The mean LMPBA was 83.62º±11.4º (range, 62.3º to 105.9º) in patients with ACL rupture, while it was 76.94º±11.46º (range, 30.8º to 96.5º) in the control group. In the receiver operating characteristics curve analysis, the cut-off value of MMPBA was 84.5, and values above this showed a 58.5% sensitivity and a 97.6% specificity for ACL rupture, whereas for LMPBA, the cut-off value was 93.15, and values above this showed a 27.3% sensitivity and a 95.1% specificity for ACL rupture. The PTS and MMPBA were significantly correlated with each other (p=0.047). The MMPBA and LMPBA were also significantly correlated with each other (p=0.011). However, there was no significant correlation between PTS and LMPBA (p=0.56).
Medial meniscus posterior base angle and LMPBA values above 84.5º and 93.15º, respectively, are new indirect magnetic resonance imaging findings of ACL injury.
本研究旨在定义内侧半月板后角基底角（MMPBA）和外侧半月板后角基底角（LMPBA），测量于内侧和外侧半月板后角，并使用这些参数检查前交叉韧带（ACL）损伤与后半月板角之间的生物力学和形态关系。
这是一项回顾性研究，共纳入 32 例 ACL 断裂患者和 40 例对照患者，共 72 例患者（40 名男性，32 名女性；平均年龄：36.3±9.9 岁；年龄范围 18 至 57 岁），纳入时间为 2016 年 1 月至 2018 年 1 月。在标准 X 线片上测量胫骨后倾角（PTS），通过标准膝关节磁共振成像评估 MMPBA 和 LMPBA 值。MMPBA 定义为穿过内侧半月板胫骨侧缘的线与穿过后角冠状位内侧半月板囊侧缘的线之间的夹角。LMPBA 定义为穿过外侧半月板胫骨侧缘的线与穿过后角冠状位外侧半月板囊侧缘的线之间的夹角。比较两组 PTS、MMPBA 和 LMPBA。
在 MMPBA 和 LMPBA 方面，与对照组相比，ACL 断裂患者的基底角明显更高（p<0.001 和 p=0.031）。ACL 断裂患者的平均 MMPBA 为 84.27º±12.59º（范围 62º至 106.1º），而对照组为 70.75º±7.85º（范围 55.1º至 88.6º）。ACL 断裂患者的平均 LMPBA 为 83.62º±11.4º（范围 62.3º至 105.9º），而对照组为 76.94º±11.46º（范围 30.8º至 96.5º）。在受试者工作特征曲线分析中，MMPBA 的截断值为 84.5，高于此值时 ACL 断裂的敏感性为 58.5%，特异性为 97.6%，而对于 LMPBA，截断值为 93.15，高于此值时 ACL 断裂的敏感性为 27.3%，特异性为 95.1%。PTS 和 MMPBA 之间存在显著相关性（p=0.047）。MMPBA 和 LMPBA 之间也存在显著相关性（p=0.011）。然而，PTS 和 LMPBA 之间无显著相关性（p=0.56）。
MMPBA 和 LMPBA 值分别大于 84.5º和 93.15º是 ACL 损伤的新的间接磁共振成像发现。
