Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
J Med Ultrason (2001). 2024 Oct;51(4):655-665. doi: 10.1007/s10396-024-01492-2. Epub 2024 Sep 2.
Some patients who undergo anterior cruciate ligament (ACL) reconstruction experience abnormal mechanical stress in the meniscus. Medial meniscal extrusion (MME) is reflected in the pathological condition of the meniscus, which expands owing to repetitive mechanical stress. Thus, the effect of the reconstructed ACL on increasing MME under weight-bearing conditions remains unclear. This study investigated the effect of ACL reconstruction on meniscal extrusion under non-weight-bearing and weight-bearing conditions.
Seventeen patients who underwent unilateral ACL reconstruction (ACL group) and 20 age-matched healthy volunteers (control group) were enrolled. Ultrasonography was performed in the supine, standing, and walking positions in preoperative and postoperative ACL patients. MME during walking was evaluated based on the dynamic behavior of extrusion, and kinetic and kinematic data were synchronously obtained. Moreover, the ACL group underwent magnetic resonance imaging (MRI) evaluation at two points: preoperatively and 12 months postoperatively, and the ultrasound findings were compared.
MME in the supine position measured using both ultrasonography and MRI was not significantly different preoperatively and postoperatively in the ACL group. However, postoperative MME and dynamic behavior of extrusion under standing and walking conditions were significantly higher than those in the preoperative state (dynamic behavior: 0.9 ± 0.4 mm preoperatively, 1.2 ± 0.4 mm postoperatively). Moreover, the deficits in knee extension during walking persisted postoperatively and were significantly higher than those in the control group.
MME in patients with ACL reconstruction including meniscus repair was different under mechanical stress compared to the non-weight bearing condition.
一些接受前交叉韧带（ACL）重建的患者在半月板中经历异常的机械应力。内侧半月板挤出（MME）反映了半月板的病理状况，由于反复的机械应力，半月板会扩张。因此，重建的 ACL 在负重条件下增加 MME 的效果尚不清楚。本研究调查了 ACL 重建对非负重和负重条件下半月板挤出的影响。
纳入 17 名接受单侧 ACL 重建（ACL 组）和 20 名年龄匹配的健康志愿者（对照组）的患者。在术前和 ACL 患者术后仰卧位、站立位和行走位进行超声检查。根据挤出的动态行为评估行走时的 MME，并同步获得运动学和运动学数据。此外，ACL 组在术前和术后 12 个月进行了磁共振成像（MRI）评估，并比较了超声检查结果。
ACL 组仰卧位时的 MME 无论是超声检查还是 MRI 检查，术前和术后均无明显差异。然而，术后站立位和行走位下的 MME 和挤出的动态行为明显高于术前（动态行为：术前 0.9±0.4mm，术后 1.2±0.4mm）。此外，术后行走时膝关节伸展的不足仍然存在，并且明显高于对照组。
与非负重状态相比，包括半月板修复的 ACL 重建患者在机械应力下的 MME 不同。
