Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Midwest Orthopaedics at Rush, Chicago, Illinois, USA.
Am J Sports Med. 2024 Nov;52(13):3427-3435. doi: 10.1177/03635465231225981. Epub 2024 Feb 16.
While increased posterior tibial slope (PTS) is an established risk factor for anterior cruciate ligament tears, the association between tibial slope and meniscal posterior root tears is not well-defined.
To summarize the available literature evaluating the association between PTS and meniscus root injuries compared with patients without root tears.
Systematic review; Level of evidence, 4.
A literature search was performed using the Scopus, PubMed, and Embase databases. Human clinical studies evaluating the associations between the medial tibial slope (MTS), lateral tibial slope (LTS), lateral-to-medial (L-to-M) slope asymmetry, and the risk of meniscus root tears were included. Patients with medial meniscus posterior root tears (MMPRTs) and lateral meniscus posterior root tears (LMPRTs) were compared with a control group without root injury. Study quality was assessed using the methodological index for non-randomized studies criteria.
Ten studies with 1313 patients were included (884 patients with root tears; 429 controls). The LMPRT subgroup (n = 284) had a significantly greater LTS (mean ± SD, 7.3°± 1.5° vs 5.7°± 3.91°; < .001), MTS (5.26°± 1.2° vs 4.8°± 1.25°; < .001), and increased L-to-M asymmetry (2.3°± 1.3° vs 0.65°± 0.5°; < .001) compared with controls. The MMPRT group (n = 600) had significantly increased MTS relative to controls (8.1°± 2.5° vs 4.3°± 0.7°; < .001). Furthermore, there was a higher incidence of noncontact injuries (79.3%) and concomitant ramp lesions (56%) reported in patients with LMPRT.
Increased MTS, LTS, and L-to-M slope asymmetry are associated with an increased risk of LMPRTs, while increased MTS is associated with MMPRTs. Surgeons should consider how proximal tibial anatomy increases the risk of meniscus root injury.
胫骨后倾角（PTS）增加是前交叉韧带撕裂的既定危险因素，但胫骨斜率与半月板后根撕裂之间的关联尚未明确。
总结评估 PTS 与半月板后根损伤之间关联的现有文献，与无后根撕裂的患者进行比较。
系统评价；证据水平，4 级。
使用 Scopus、PubMed 和 Embase 数据库进行文献检索。纳入评估内侧胫骨斜率（MTS）、外侧胫骨斜率（LTS）、外侧到内侧（L-to-M）斜率不对称与半月板后根撕裂风险之间关联的人类临床研究。内侧半月板后根撕裂（MMPRT）和外侧半月板后根撕裂（LMPRT）患者与无根损伤的对照组进行比较。使用非随机研究方法学指数评估研究质量。
纳入了 10 项研究共 1313 例患者（884 例有根撕裂；429 例对照）。LMPRT 亚组（n=284）的 LTS（平均值±标准差，7.3°±1.5° vs 5.7°±3.91°；<.001）、MTS（5.26°±1.2° vs 4.8°±1.25°；<.001）和增加的 L-to-M 不对称（2.3°±1.3° vs 0.65°±0.5°；<.001）明显更大，与对照组相比。MMPRT 组（n=600）的 MTS 明显高于对照组（8.1°±2.5° vs 4.3°±0.7°；<.001）。此外，LMPRT 患者报告的非接触性损伤发生率（79.3%）和伴发斜坡病变（56%）更高。
MTS、LTS 和 L-to-M 斜率不对称与 LMPRT 风险增加相关，而 MTS 增加与 MMPRT 相关。外科医生应考虑胫骨近端解剖结构如何增加半月板后根损伤的风险。
