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前交叉韧带损伤患者中半月板撕裂、胫骨坡度、静态膝关节位置与膝关节前向松弛之间的关联

The Association Between Concomitant Meniscal Tear, Tibial Slope, Static Knee Position, and Anterior Knee Laxity in ACL-Deficient Patients.

作者信息

Huang Tzu-Ching, Wang Chi-Hsiu, Hsu Kai-Lan, Kuan Fa-Chuan, Su Wei-Ren, Hong Chih-Kai

机构信息

Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Orthop J Sports Med. 2025 Mar 21;13(3):23259671251324186. doi: 10.1177/23259671251324186. eCollection 2025 Mar.

Abstract

BACKGROUND

Whether the tibial slope or the concomitant meniscal tear is related to static knee position or anterior knee laxity remains controversial.

PURPOSE

To investigate the association between medial and lateral posterior tibial slope, concomitant meniscal tear, static knee position using magnetic resonance imaging (MRI), and anterior knee laxity measured with the GNRB arthrometer.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A total of 60 patients who underwent anterior cruciate ligament (ACL) reconstructions were retrospectively enrolled from May 2020 to October 2022. All patients underwent both MRI and GNRB arthrometry after the injury. The static knee position and medial and lateral tibial slopes were measured using MRI. The meniscal tear type was confirmed during arthroscopic surgery. Descriptive data were retrospectively reviewed from the medical records.

RESULTS

The side-to-side differences of anterior tibial translation at 134 N in the intact meniscus, isolated lateral meniscal tear, isolated medial meniscal tear, and both meniscal tear groups were 3.63 ± 1.4 mm, 4.61 ± 1.5 mm, 2.85 ± 1.5 mm, and 4.85 ± 1.6 mm, respectively ( = .003). The slopes of the force-displacement curve in the GNRB arthrometer were 6.55 ± 4.8 mm/N, 16.99 ± 5.6 mm/N, 9.69 ± 10.8 mm/N, and 10.89 ± 7.4 mm/N in the intact meniscus, lateral meniscal tear, medial meniscal tear, and both meniscal tear groups, respectively ( = .001). Subgroup analysis showed that patients with lateral meniscal tears tended to have greater anterior knee laxity based on the GNRB arthrometer tests. The medial and lateral tibial slopes were not correlated with static knee position or anterior knee laxity.

CONCLUSION

Patients with ACL deficiency and concomitant lateral meniscal tears are more likely to exhibit greater anterior knee laxity, as measured using the GNRB. Clinicians should consider the concomitant lateral meniscal tear when planning surgery and arranging postoperative care. Tibial slopes were not found to be correlated with static knee position or anterior knee laxity.

摘要

背景

胫骨坡度或伴随的半月板撕裂是否与静态膝关节位置或膝关节前向松弛有关仍存在争议。

目的

利用磁共振成像(MRI)研究胫骨后内侧和外侧坡度、伴随的半月板撕裂、静态膝关节位置之间的关联,以及使用GNRB关节测量仪测量的膝关节前向松弛情况。

研究设计

横断面研究;证据等级,3级。

方法

回顾性纳入2020年5月至2022年10月期间共60例行前交叉韧带(ACL)重建的患者。所有患者在受伤后均接受了MRI和GNRB关节测量。使用MRI测量静态膝关节位置以及胫骨内侧和外侧坡度。在关节镜手术期间确认半月板撕裂类型。从病历中回顾性审查描述性数据。

结果

完整半月板组、孤立外侧半月板撕裂组、孤立内侧半月板撕裂组以及双侧半月板撕裂组在134 N时胫骨前向平移的左右差异分别为3.63±1.4 mm、4.61±1.5 mm、2.85±1.5 mm和4.85±1.6 mm(P = .003)。GNRB关节测量仪中力-位移曲线的斜率在完整半月板组、外侧半月板撕裂组、内侧半月板撕裂组以及双侧半月板撕裂组中分别为6.55±4.8 mm/N、16.99±5.6 mm/N、9.69±10.8 mm/N和10.89±7.4 mm/N(P = .001)。亚组分析表明,根据GNRB关节测量仪测试,外侧半月板撕裂的患者往往有更大的膝关节前向松弛。胫骨内侧和外侧坡度与静态膝关节位置或膝关节前向松弛无关。

结论

ACL缺失并伴有外侧半月板撕裂的患者,使用GNRB测量时更有可能表现出更大的膝关节前向松弛。临床医生在计划手术和安排术后护理时应考虑伴随外侧半月板撕裂的情况。未发现胫骨坡度与静态膝关节位置或膝关节前向松弛有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71fa/11930474/451e77605ef5/10.1177_23259671251324186-fig1.jpg

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