Ito Ryu, Watanabe Shotaro, Sakamoto Takuya, Toguchi Kaoru, Horii Manato, Kimura Seiji, Yamaguchi Satoshi, Ohtori Seiji, Sasho Takahisa
Center for Preventive Medical Sciences, Chiba University, Chiba, JPN.
Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, JPN.
Cureus. 2024 Sep 23;16(9):e69987. doi: 10.7759/cureus.69987. eCollection 2024 Sep.
The risk of post-traumatic osteoarthritis remains high even after anterior cruciate ligament reconstruction (ACLR). Medial meniscal extrusion (MME) is a valuable clinical sign as an early morphological change. This study aimed to analyze MME before and after ACLR and investigate the factors affecting postoperative MME.
This study included patients who underwent anatomical double-bundle ACLR between January 2016 and July 2021. MME was measured using MRI preoperatively and one year postoperatively. The medial meniscus (MM) treatments were categorized into three groups: no MM injury and no repair (no injury/no repair (N/N)), MM injury but no repair (injury/no repair (I/N)), and MM injury and repair (injury/repair (I/R)). We investigated the factors influencing MME after ACLR using multiple linear regression analysis and compared MME before and after ACLR using paired t-tests.
This study included 133 patients, of whom 90 (37 males and 53 females) were analyzed. The mean age of the patients at surgery was 27.5 years, and 41, 27, and 22 patients were assigned into N/N, I/N, and I/R groups, respectively. Preoperative MME (p<0.001) and I/R (p<0.001) had significant effects on postoperative MME in a regression analysis. Postoperative MME had greater effects than the preoperative MME in all cases (1.16 and 1.53 mm (p<0.01)) and in every MM treatment group (N/N: 1.02 and 1.32 mm (p<0.01), I/N: 1.16 and 1.44 mm (p<0.01), and I/R: 1.42 and 2.05 mm (p<0.001)).
Larger preoperative MME and receiving MM repair were significantly associated with a larger MME after ACLR. Postoperative MME in ACLR patients was significantly greater than preoperative MME.
即使在前交叉韧带重建（ACLR）术后，创伤后骨关节炎的风险仍然很高。内侧半月板挤压（MME）作为一种早期形态学改变，是一个有价值的临床体征。本研究旨在分析ACLR前后的MME，并探讨影响术后MME的因素。
本研究纳入了2016年1月至2021年7月期间接受解剖双束ACLR的患者。术前及术后1年使用MRI测量MME。内侧半月板（MM）治疗分为三组：无MM损伤且未修复（无损伤/未修复（N/N））、MM损伤但未修复（损伤/未修复（I/N））以及MM损伤且修复（损伤/修复（I/R））。我们使用多元线性回归分析研究影响ACLR术后MME的因素，并使用配对t检验比较ACLR前后的MME。
本研究纳入133例患者，其中90例（37例男性和53例女性）进行了分析。患者手术时的平均年龄为27.5岁，分别有41例、27例和22例患者被分配到N/N、I/N和I/R组。在回归分析中，术前MME（p<0.001）和I/R（p<0.001）对术后MME有显著影响。在所有病例中（1.16和1.53 mm（p<0.01））以及每个MM治疗组中（N/N：1.02和1.32 mm（p<0.01），I/N：1.16和1.44 mm（p<0.01），I/R：1.42和2.05 mm（p<0.001）），术后MME的影响均大于术前MME。
术前MME较大以及接受MM修复与ACLR术后较大的MME显著相关。ACLR患者术后的MME显著大于术前MME。
