超声检查内侧半月板退行性撕裂与内侧半月板挤出及动力学之间的相关性

Correlation between medial meniscus degenerative tears and medial meniscus extrusion and dynamics using ultrasonography.

作者信息

Asai Kazuki, Nakase Junsuke, Shima Yosuke, Goshima Kenichi, Kuroda Kazunari, Oshima Takeshi, Kimura Mitsuhiro, Shimozaki Kengo, Kanayama Tomoyuki, Takemoto Naoki, Nishimura Manase, Demura Satoru

机构信息

Department of Orthopedic Surgery, Keiju Medical Center, 94 Tomioka-machi, Nanao-city, 926-8605, Japan; Department of Orthopedic Surgery, Graduate School of Medical Science Kanazawa University, 13-1 Takara-machi, Kanazawa-city, 920-8641, Japan.

Department of Orthopedic Surgery, Graduate School of Medical Science Kanazawa University, 13-1 Takara-machi, Kanazawa-city, 920-8641, Japan.

出版信息

J Orthop Sci. 2025 Sep;30(5):850-855. doi: 10.1016/j.jos.2024.12.008. Epub 2025 Jan 16.

DOI:10.1016/j.jos.2024.12.008

PMID:39824701

Abstract

BACKGROUND

Evaluating the correlation between degenerative meniscus tears and medial meniscus extrusion is necessary to determine the appropriate treatment plan for early-stage knee osteoarthritis. This study evaluated the relationship between degenerative meniscal tears and medial meniscus extrusion in early-stage knee osteoarthritis by using ultrasonography.

METHODS

A total of 132 knees from 123 patients with early-stage knee osteoarthritis were evaluated retrospectively. Medial meniscus extrusion at knee flexion angles of 0° and 90°, and meniscal degenerative tears, were evaluated using ultrasonography and magnetic resonance imaging. Medial meniscus extrusion was classified into four grades, while degenerative meniscal tears were categorized into five types as follows: type 0, no tear or only degenerative changes; type 1, horizontal tear only in the posterior segment of the medial meniscus; type 2, horizontal tear shown in both the posterior and middle segments of the medial meniscus; type 3, flap tear or maceration of the medial meniscus; type 4, medial meniscus posterior root tear or radial tear. Correlations between the type of meniscal tear and the medial meniscus extrusion grade in each meniscal tear group were evaluated.

RESULTS

The meniscal tear type was significantly correlated with the medial meniscus extrusion grade (r = 0.518, p = 0.001). The percentages of cases with medial meniscus extrusion grade 2 or 3 (i.e., medial meniscus extrusion >3 mm at knee flexion angle of 0°) were 23.8 %, 50.0 %, 86.8 %, 94.1 %, and 92.3 % for types 0-4, respectively. The percentages of cases with medial meniscus extrusion >3 mm at knee flexion angles of 0° and 90° were 0 %, 20.0 %, 52.6 %, 70.6 %, and 50.0 % for types 0-4, respectively.

CONCLUSION

The more severe the meniscal degenerative tear, the greater the medial meniscus extrusion and the more abnormal the dynamics in early-stage knee osteoarthritis.

摘要

背景

评估退行性半月板撕裂与内侧半月板挤出之间的相关性对于确定早期膝关节骨关节炎的合适治疗方案至关重要。本研究通过超声检查评估早期膝关节骨关节炎中退行性半月板撕裂与内侧半月板挤出之间的关系。

方法

回顾性评估123例早期膝关节骨关节炎患者的132个膝关节。使用超声检查和磁共振成像评估膝关节屈曲角度为0°和90°时的内侧半月板挤出情况以及半月板退行性撕裂情况。内侧半月板挤出分为四个等级，而退行性半月板撕裂分为以下五种类型：0型，无撕裂或仅有退行性改变；1型，仅在内侧半月板后段出现水平撕裂；2型，在内侧半月板后段和中段均出现水平撕裂；3型，内侧半月板瓣状撕裂或糜烂；4型，内侧半月板后根撕裂或放射状撕裂。评估每个半月板撕裂组中半月板撕裂类型与内侧半月板挤出等级之间的相关性。

结果

半月板撕裂类型与内侧半月板挤出等级显著相关（r = 0.518，p = 0.001）。0 - 4型患者中，内侧半月板挤出等级为2级或3级（即膝关节屈曲角度为0°时内侧半月板挤出>3 mm）的病例百分比分别为23.8%、50.0%、86.8%、94.1%和92.3%。0 - 4型患者中，膝关节屈曲角度为0°和90°时内侧半月板挤出>3 mm的病例百分比分别为0%、20.0%、52.6%、70.6%和50.0%。