Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Knee Surg Sports Traumatol Arthrosc. 2023 Jun;31(6):2358-2365. doi: 10.1007/s00167-022-07161-6. Epub 2022 Sep 16.
This study aimed to compare the amount of extrusion of the discoid lateral meniscus (DLM), which was symptomatic and required surgery, with normal meniscuses and asymptomatic DLMs and examine factors associated with the extrusion of symptomatic DLM.
Medical records of participants with DLM or normal lateral meniscus (LM) were retrospectively reviewed using magnetic resonance imaging (MRI). DLM cases were divided into symptomatic and asymptomatic groups. The midbody meniscal extrusion was measured using mid-coronal MRI. The association between meniscal extrusion and MRI findings, including the meniscofemoral ligament, meniscotibial ligament (MTL), intrameniscal signal intensity of the peripheral rim, meniscal shift, and skeletal maturity, was evaluated.
Eighty-six knees with DLM (63 symptomatic) were included. The control group included 31 patients. The symptomatic group showed significantly greater meniscal extrusion (mean ± standard deviation symptomatic DLM: 1.0 ± 1.1 mm, asymptomatic DLM: 0.1 ± 0.4 mm, and normal LM: 0.3 ± 0.6 mm, P < 0.001) and had a significantly higher incidence of MTL loosening (P = 0.02) and intrameniscal signal (P < 0.001) than the other two groups. In the symptomatic group, multivariable linear regression analysis showed that MTL loosening [β = 1.45, 95% confidence interval (CI) 1.03-1.86, P < 0.001] and intrameniscal signal (β = 0.49, 95% CI 0.09-0.90, P = 0.002) were independent associated factors.
LM extrusion was significantly more common in patients with symptomatic DLM than in those with asymptomatic DLM or a normal LM. MTL loosening and intrameniscal high-signal intensity on MRI were independently associated with meniscal extrusion. These findings help explain the pathogenesis and diagnosis of symptomatic DLM.
III.
本研究旨在比较有症状并需要手术的盘状外侧半月板（DLM）的挤出量与正常半月板和无症状 DLM，并探讨与症状性 DLM 挤出相关的因素。
使用磁共振成像（MRI）对有 DLM 或正常外侧半月板（LM）的参与者的病历进行回顾性分析。将 DLM 病例分为有症状和无症状两组。使用中冠状位 MRI 测量半月板体部挤出量。评估半月板挤出与 MRI 发现之间的关系，包括半月板股骨韧带、半月板胫骨韧带（MTL）、半月板外周缘的内部信号强度、半月板移位和骨骼成熟度。
共纳入 86 个 DLM 膝关节（63 个有症状），对照组包括 31 个患者。与其他两组相比，症状组的半月板挤出量明显更大（有症状 DLM：1.0±1.1mm，无症状 DLM：0.1±0.4mm，正常 LM：0.3±0.6mm，P<0.001），且 MTL 松弛（P=0.02）和半月板内信号（P<0.001）的发生率更高。在症状组中，多变量线性回归分析显示 MTL 松弛[β=1.45，95%置信区间（CI）1.03-1.86，P<0.001]和半月板内信号（β=0.49，95%CI 0.09-0.90，P=0.002）是独立相关因素。
与无症状 DLM 或正常 LM 患者相比，有症状 DLM 患者的 LM 挤出更为常见。MTL 松弛和半月板内高信号强度与半月板挤出有关。这些发现有助于解释症状性 DLM 的发病机制和诊断。
III。
