Familiari Filippo, Tollefson Luke V, Izzo Antonio, Mercurio Michele, LaPrade Robert F, Di Vico Giovanni
Department of Orthopaedic and Trauma Surgery, Magna Graecia University, 88100 Catanzaro, Italy.
Research Center on Musculoskeletal Health, MusculoSkeletal Health@UMG, Magna Graecia University, 88100 Catanzaro, Italy.
J Clin Med. 2024 Jan 24;13(3):683. doi: 10.3390/jcm13030683.
Medial meniscus ramp tears are present in 22.9-40.8% of anterior cruciate ligament tears. The diagnosis of ramp tears is difficult on MRI, with sensitivity reported around 48%, which has recently emphasized the importance of proper arthroscopic probing for ramp tears. A prospective evaluation was performed on patients undergoing a single bundle ACL reconstruction to assess patient demographics, posterior tibial slope, posterior cruciate ligament angle, Lachman's exam, and rotational instability to determine secondary findings associated with medial meniscal ramp tears. A total of 96 patients underwent ACL reconstruction, of these, 63 patients had an isolated ACL tear, and 33 patients had an ACL tear with a concomitant medial meniscus ramp tear. A high-grade Lachman's exam and male sex were associated with medial meniscus ramp tears. There were no differences in posterior tibial slope, posterior cruciate ligament angle, or rotational instability between groups. This study found that a high-grade Lachman's exam and male sex were significantly associated with patients with an ACL tear with a concomitant medial meniscus ramp tear. These findings suggest that an ACL tear with concomitant medial meniscus ramp tear may be better diagnosed based upon the clinical evaluation rather than other secondary radiological findings.
内侧半月板斜坡状撕裂存在于22.9%至40.8%的前交叉韧带撕裂病例中。斜坡状撕裂在磁共振成像（MRI）上很难诊断，其敏感性约为48%，这最近凸显了对斜坡状撕裂进行适当关节镜探查的重要性。对接受单束前交叉韧带重建的患者进行了一项前瞻性评估，以评估患者的人口统计学特征、胫骨后倾、后交叉韧带角度、拉赫曼试验以及旋转不稳情况，以确定与内侧半月板斜坡状撕裂相关的次要发现。共有96例患者接受了前交叉韧带重建，其中63例患者为单纯前交叉韧带撕裂，33例患者为前交叉韧带撕裂合并内侧半月板斜坡状撕裂。拉赫曼试验为高级别及男性性别与内侧半月板斜坡状撕裂相关。两组之间在胫骨后倾、后交叉韧带角度或旋转不稳方面没有差异。本研究发现，拉赫曼试验为高级别及男性性别与前交叉韧带撕裂合并内侧半月板斜坡状撕裂的患者显著相关。这些发现表明，对于前交叉韧带撕裂合并内侧半月板斜坡状撕裂，基于临床评估可能比基于其他次要影像学发现能更好地做出诊断。
