Health Sciences University Samsun Training and Research Hospital, Department of Orthopaedics and Traumatology, Samsun, Turkey.
Health Sciences University Samsun Training and Research Hospital, Department of Orthopaedics and Traumatology, Samsun, Turkey.
Arthroscopy. 2023 Oct;39(10):2154-2163. doi: 10.1016/j.arthro.2023.02.020. Epub 2023 Mar 1.
To investigate the correlation between nontraumatic medial meniscus posterior root tear (MMPRT) and bone morphology of the knee with a particular emphasis on MMPR impingement.
Magnetic resonance imaging (MRI) findings were examined between January 2018 and December 2020. MRI findings of patients with traumatic MMPRT, Kellgren Lawrence stage 3-4 arthropathy on radiographs, single- or multiple-ligament injuries and/or those who underwent treatment for these diseases, and surgery in and around the knee were excluded from the study. MRI measurements included medial femoral condylar angle (MFCA), intercondylar distance (ICD), and intercondylar notch width (ICNW), distal/posterior medial femoral condylar offset ratio, notch shape, medial tibial slope (MTS) angle, and medial proximal tibial angle (MPTA) measurements and spur presence and were compared between groups. All measurements were performed by two board-certified orthopedic surgeons on a best agreement basis.
MRI examinations of patients aged 40-60 were analyzed. MRI findings were divided into two groups: the study group of MRI findings of patients with MMPRT (n = 100) and the control group of MRI findings of patients without MMPRT (n = 100). MFCA was found to be significantly higher in the study group (mean: 46.5 ± 3.58) than in the control group (mean: 40.04 ± 4.61) (P < .001). In the study group, the ICD (study group mean: 76.26 ± 4.89; control group mean: 78.18 ± 6.1) was significantly narrower (P = .018), and the ICNW (study group mean: 17.19 ± 2.23; control group mean: 20.48 ± 2.13) was significantly shorter (P < .001). The ICNW/ICD ratio was significantly lower in patients in the study group (0.22 ± 0.02) than in the control group (0.25 ± 0.02) (P < .001). Bone spurs were present in 84% of the study group and only in 28% of those in the control group. In the study group, the most common notch type was A-type with 78%, while the least common was the U-type notch with 10%. However, in the control group, the most common notch type was A-type with 43%, and the least common was the W-type notch with 22%. The distal/posterior medial femoral condylar offset ratio was statistically lower in the study group (0.72 ± 0.07) than in the control group 0.78 ± 0.07) (P < .001). No significant intergroup differences were found in MTS (study group mean: 7.51 ±2.59; control group mean: 7.83 ± 2.57) (P = .390) and MPTA (study group mean: 86.92 ±2.15; control group mean: 87.48 ±1.8) measurements (P = .67).
Increased medial femoral condylar angle, low distal/posterior femoral offset ratio, narrow intercondylar distance and intercondylar notch width, A-type notch shape, and spur presence are associated with MMPRT.
Level III, retrospective cohort study.
研究非外伤性内侧半月板后根撕裂（MMPRT）与膝关节骨形态之间的相关性，特别关注 MMPRT 撞击。
研究纳入了 2018 年 1 月至 2020 年 12 月期间的磁共振成像（MRI）检查结果。研究排除了创伤性 MMPRT、放射学上 Kellgren Lawrence 3-4 级关节炎、单一或多发韧带损伤和/或这些疾病的治疗以及膝关节内外手术的患者。MRI 测量包括内侧股骨髁角（MFCA）、髁间距离（ICD）和髁间切迹宽度（ICNW）、远端/后内侧股骨髁偏移比、切迹形状、内侧胫骨倾斜角（MTS）和内侧近端胫骨角（MPTA）测量值以及骨刺的存在，并对两组进行了比较。所有测量均由两名具有认证资质的骨科医生在最佳一致的基础上进行。
分析了年龄在 40-60 岁之间的患者的 MRI 检查结果。MRI 结果分为两组：MRI 发现有 MMPRT 的患者（研究组，n=100）和 MRI 发现无 MMPRT 的患者（对照组，n=100）。研究组的 MFCA（平均：46.5±3.58）明显高于对照组（平均：40.04±4.61）（P<0.001）。在研究组中，ICD（研究组平均值：76.26±4.89；对照组平均值：78.18±6.1）明显较窄（P=0.018），ICNW（研究组平均值：17.19±2.23；对照组平均值：20.48±2.13）明显较短（P<0.001）。研究组的 ICNW/ICD 比值（0.22±0.02）明显低于对照组（0.25±0.02）（P<0.001）。84%的研究组存在骨赘，而对照组仅为 28%。在研究组中，最常见的切迹类型是 A 型，占 78%，而最少见的是 U 型切迹，占 10%。然而，在对照组中，最常见的切迹类型是 A 型，占 43%，最少见的是 W 型切迹，占 22%。研究组的远端/后内侧股骨髁偏移比（0.72±0.07）明显低于对照组（0.78±0.07）（P<0.001）。研究组的 MTS（研究组平均值：7.51±2.59；对照组平均值：7.83±2.57）（P=0.390）和 MPTA（研究组平均值：86.92±2.15；对照组平均值：87.48±1.8）测量值（P=0.67）之间无明显的组间差异。
内侧股骨髁角增大、远端/后内侧股骨髁偏移比降低、髁间距离和髁间切迹宽度变窄、A 型切迹形状和骨赘存在与 MMPRT 有关。
III 级，回顾性队列研究。
