Oeding Jacob F, Dean Michael C, Hevesi Mario, Chahla Jorge, Krych Aaron J
Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
School of Medicine, Mayo Clinic Alix School of Medicine, Rochester, Minnesota, U.S.A.
Arthroscopy. 2024 Nov 4. doi: 10.1016/j.arthro.2024.10.031.
To evaluate the available literature on the relationship between knee bony morphology and medial meniscus posterior root tears (MMPRTs) to determine which tibiofemoral morphologic risk factors may predispose the development of MMPRTs.
Embase, MEDLINE, and PubMed databases were searched to identify all relevant human clinical studies investigating knee morphologic features and MMPRTs. Shape features were compared between control groups and patients with MMPRTs. The methodological index for nonrandomized studies (MINORS) instrument was utilized to assess the methodological quality of included studies.
Thirteen level III evidence studies and 1 level IV evidence study were included in this review (n = 2,181), with 895 patients in the MMPRT group and 1,286 in the control group. Tibial morphology features associated with an increased risk for MMPRTs included an increased medial tibial slope (6 studies), increased tibial torsion (1 study), increased medial meniscal slope (1 study), and shallower medial tibial plateau concavity (1 study). Varus mechanical alignment was found to increase the risk for MMPRTs (4 studies). Femoral morphology features associated with an increased risk for MMPRTs included an A-type intercondylar notch (1 study), increased medial femoral condyle (MFC) angle (1 study), narrower intercondylar distance (1 study), narrower intercondylar notch width (1 study), shorter MFC distal offset distance (1 study), increased MFC width (1 study), increased MFC to medial tibial condyle width ratio (1 study), greater distance between the medial tibial eminence and MFC (1 study), and smaller femoral offset ratios of both the medial and lateral condyles (1 study).
Multiple tibiofemoral shape features, including a steeper slope of the medial tibial plateau, greater varus alignment, and a narrower intercondylar distance and notch width, were found to be predictive factors for MMPRTs.
Level IV (Systematic review of Level III and IV studies).
评估关于膝关节骨形态与内侧半月板后根撕裂（MMPRTs）之间关系的现有文献，以确定哪些胫股形态学危险因素可能易患MMPRTs。
检索Embase、MEDLINE和PubMed数据库，以识别所有研究膝关节形态特征和MMPRTs的相关人体临床研究。比较对照组和MMPRTs患者之间的形状特征。使用非随机研究方法学指数（MINORS）工具评估纳入研究的方法学质量。
本综述纳入了13项III级证据研究和1项IV级证据研究（n = 2,181），MMPRTs组有895例患者，对照组有1,286例患者。与MMPRTs风险增加相关的胫骨形态特征包括内侧胫骨坡度增加（6项研究）、胫骨扭转增加（1项研究）、内侧半月板坡度增加（1项研究）和内侧胫骨平台凹陷变浅（1项研究）。发现内翻机械对线会增加MMPRTs的风险（4项研究）。与MMPRTs风险增加相关的股骨形态特征包括A型髁间切迹（1项研究）、内侧股骨髁（MFC）角度增加（1项研究）、髁间距离变窄（1项研究）、髁间切迹宽度变窄（1项研究）、MFC远端偏移距离缩短（1项研究）、MFC宽度增加（1项研究）、MFC与内侧胫骨髁宽度比增加（1项研究）、内侧胫骨隆起与MFC之间的距离更大（1项研究）以及内侧和外侧髁的股骨偏移率更小（1项研究）。
发现多个胫股形状特征，包括内侧胫骨平台坡度更陡、内翻对线更大以及髁间距离和切迹宽度更窄，是MMPRTs的预测因素。
IV级（III级和IV级研究的系统评价）。
