Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Br J Radiol. 2023 Jun 1;96(1146):20220944. doi: 10.1259/bjr.20220944. Epub 2023 Mar 16.
To assess if posterior oblique ligament and distal semi-membranosus tendon tears are associated with posterior horn medial meniscus tears on MRI.
From January 1, 2018 to December 31, 2019, 56 patients who met the inclusion criteria were enrolled in this study. Of the 56 patients, 43 patients who had a posterior horn of medial meniscus tear were included in the study group. A control group of 13 individuals was formed for comparison. Two radiologists reviewed the MR images and recorded the presence and grades of posterior oblique ligament and distal semi-membranosus tendon tears. We used the independent -test and one-way ANOVA to compare the tear grades. Interobserver agreement was analyzed using a Cohen's κ coefficient (κ value) for categorical variables.
The mean grades for the posterior oblique ligament and distal semi-membranosus tendon tears were significantly higher in the study group (all, < 0.001). Interobserver agreement between the two readers was substantial in assessing the grade of posterior oblique ligament tear (κ = 0.653±0.087) and almost perfect in assessing the grade of distal semi-membranosus tendon tear (κ = 0.876±0.060).
Posterior oblique ligament and distal semi-membranosus tendon tears are significantly associated with posterior horn of medial meniscus tear and medial meniscus posterior root tears, and the peel-back mechanism could be related to this association.
Presenting this paper could adjust radiologist search patterns and potentially help orthopedists with management and pre-surgical planning for the posteromedial corner injury of the knee.
评估 MRI 上后斜韧带和远端半膜肌腱撕裂与内侧半月板后角撕裂的关系。
本研究纳入了 2018 年 1 月 1 日至 2019 年 12 月 31 日符合纳入标准的 56 名患者。在这 56 名患者中,有 43 名患者的内侧半月板后角撕裂被纳入研究组。为了进行比较,还建立了一个包含 13 名个体的对照组。两名放射科医生对 MRI 图像进行了回顾,并记录了后斜韧带和远端半膜肌腱撕裂的存在和程度。我们使用独立样本 t 检验和单因素方差分析来比较撕裂程度。使用 Cohen's κ 系数(κ 值)对分类变量进行观察者间一致性分析。
研究组后斜韧带和远端半膜肌腱撕裂的平均程度明显更高(均<0.001)。两位观察者在评估后斜韧带撕裂程度方面的观察者间一致性为中等(κ=0.653±0.087),在评估远端半膜肌腱撕裂程度方面的观察者间一致性为几乎完美(κ=0.876±0.060)。
后斜韧带和远端半膜肌腱撕裂与内侧半月板后角撕裂和内侧半月板后根撕裂明显相关,撕脱机制可能与这种相关性有关。
本研究结果可能会调整放射科医生的搜索模式,并有助于骨科医生对膝关节后内侧角损伤进行管理和术前规划。