全层盘状外侧半月板切除术与外侧股骨髁和胫骨平台形态变化有关。
Saucerization of complete discoid lateral meniscus is associated with change of morphology of the lateral femoral condyle and tibial plateau.
机构信息
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.
出版信息
Arch Orthop Trauma Surg. 2023 Dec;143(12):7019-7026. doi: 10.1007/s00402-023-04999-4. Epub 2023 Jul 31.
PURPOSE
To determine the effect of saucerization surgery on knee joint morphology associated with a complete discoid lateral meniscus (DLM) using magnetic resonance (MR) imaging.
METHODS
This retrospective study included cases had undergone saucerization surgery for symptomatic DLM between 2007 and 2022. All cases were divided into two by age group: < 12 (U13) and > 13 (O13). The cases in the match group were randomly selected from preoperative cases in the O13 group matched with the age at the final follow-up (F/U) of cases in the U13 group. The following morphological parameters were evaluated using MR images preoperatively and at the final postoperative F/U in each group: anterior obliquity of the lateral tibial plateau (AOLTP), posterior obliquity of the lateral tibial plateau (POLTP), and the lowest point of the lateral femoral condyle (LPLFC). Each parameter was compared between the U13 preoperative (pre-OP) group and the O13 pre-OP group, the preoperative and final follow-up in the U13, and the U13 group at the final F/U and the match group preoperatively.
RESULTS
A total of 77 cases were evaluated. 31 cases were in the U13 pre-OP group and 46 were in the O13 pre-OP group. With a minimal F/U of 2 years, 27 cases in the U13 group and 36 in the O13 group were included. The mean F/U period was 4.6 years in the U13 group and 3.2 years in the O13 group. 32 cases were included in the match group. In the match group, the inclination of the POLTP was significantly larger (P = 0.042) and the LPLFC was more lateral (P = 0.0034) than at the final F/U in the U13 group.
CONCLUSIONS
Saucerization surgery for DLM in juvenile patients can prevent progression to the characteristic bone morphology DLM. These results could help the surgeon making the decision when the surgery would be performed for symptomatic DLM patients.
LEVEL OF EVIDENCE
Retrospective comparative study; level of evidence, 3.
目的
通过磁共振成像（MR）来确定盘状外侧半月板（DLM）完全撕裂后行盘状半月板切除术对膝关节形态的影响。
方法
本回顾性研究纳入了 2007 年至 2022 年期间因有症状的 DLM 而行盘状半月板切除术的病例。所有病例均按年龄分为两组：<12 岁（U13 组）和>13 岁（O13 组）。匹配组中的病例是从 O13 组的术前病例中随机选择的，其年龄与 U13 组的最终随访（F/U）年龄相匹配。在每组中，使用术前和最终术后 F/U 的 MR 图像评估以下形态学参数：外侧胫骨平台前倾角（AOLTP）、外侧胫骨平台后倾角（POLTP）和外侧股骨髁最低点（LPLFC）。比较 U13 术前（术前）组与 O13 术前组、U13 术前与最终 F/U 组、U13 最终 F/U 组与匹配组术前的各项参数。
结果
共评估了 77 例患者。U13 术前组 31 例，O13 术前组 46 例。U13 组有 27 例，O13 组有 36 例，随访时间至少 2 年，纳入研究。U13 组的平均随访时间为 4.6 年，O13 组为 3.2 年。匹配组纳入 32 例。在匹配组中，POLTP 的倾斜度明显更大（P = 0.042），LPLFC 更偏外侧（P = 0.0034），与 U13 组的最终 F/U 相比。
结论
青少年患者的盘状半月板切除术可以预防盘状半月板特征性骨形态的进展。这些结果可以帮助外科医生在决定对有症状的盘状半月板患者进行手术时做出决策。
证据水平
回顾性对比研究；证据水平，3 级。
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