Familiari Filippo, Tollefson Luke V, Izzo Antonio, Russo Raffaella, Mercurio Michele, Gasparini Giorgio, LaPrade Robert F, Di Vico Giovanni
Department of Orthopaedic and Trauma Surgery Magna Graecia University Catanzaro Italy.
Research Center on Musculoskeletal Health, MusculoSkeletal Health@UMG Magna Graecia University Catanzaro Italy.
J Exp Orthop. 2025 Apr 13;12(2):e70238. doi: 10.1002/jeo2.70238. eCollection 2025 Apr.
The purpose of this study was to evaluate potential predictive diagnostic variables on magnetic resonance imaging (MRI) for medial meniscus ramp tears in the presence of an anterior cruciate ligament (ACL) tear.
Patients aged ≥16 years undergoing arthroscopic anatomic hamstring single-bundle ACL reconstruction between July 2016 and September 2020 from a single centre were prospectively enroled with a diagnosis based on clinical and MRI evaluations. Demographic data such as age, gender, dominant limb and time from injury to surgery were recorded. Clinical assessments included Lachman and pivot shift tests. Imaging assessments involved grading bone bruises on MRI using the International Cartilage Repair Society (ICRS) scale. Statistical analysis was conducted using parametric tests and regression analysis with a value of less than 0.05, which is considered significant.
The final sample consisted of 108 patients, with a concomitant ACL tear and medial meniscus ramp tear present in 53 (49.1%) patients. In the univariate regression analysis, a higher grade of the medial femoral condyle and medial tibial plateau bone bruises was highly associated with the diagnosis of an ACL tear with a concomitant ramp tear ( = 0.006, = 0.151 and < 0.001, = 0.172, respectively). In the univariate regression analysis, a higher grade of the medial femoral condyle and medial tibial plateau bone bruise was associated with the diagnosis of ACL tear with a concomitant ramp tear ( = 0.006, = 0.151 and < 0.001, = 0.172, respectively).
In this prospective series of patients with ACL tears, 49% were found to have concomitant medial meniscal ramp tears. The finding of medial tibial plateau or medial femoral condyle bone bruising was predictive of ramp tear. The presence of this bone bruising pattern along with a high-grade Lachman and/or pivot shift examination, a medial meniscus ramp tear should be suspected.
Level II, prospective cohort study.
本研究旨在评估存在前交叉韧带（ACL）撕裂时，磁共振成像（MRI）上内侧半月板斜行撕裂的潜在预测性诊断变量。
对2016年7月至2020年9月在单一中心接受关节镜下解剖双束腘绳肌单束ACL重建的年龄≥16岁患者进行前瞻性登记，诊断基于临床和MRI评估。记录年龄、性别、优势肢体以及受伤至手术时间等人口统计学数据。临床评估包括拉赫曼试验和轴移试验。影像学评估包括使用国际软骨修复协会（ICRS）量表对MRI上的骨挫伤进行分级。采用参数检验和回归分析进行统计分析，P值小于0.05被认为具有统计学意义。
最终样本包括108例患者，其中53例（49.1%）同时存在ACL撕裂和内侧半月板斜行撕裂。在单变量回归分析中，股骨内侧髁和胫骨内侧平台骨挫伤的较高分级与伴有斜行撕裂的ACL撕裂诊断高度相关（分别为P = 0.006，β = 0.151和P < 0.001，β = 0.172）。在单变量回归分析中，股骨内侧髁和胫骨内侧平台骨挫伤的较高分级与伴有斜行撕裂的ACL撕裂诊断相关（分别为P = 0.006，β = 0.151和P < 0.001，β = 0.172）。
在这个前瞻性系列ACL撕裂患者中，发现49%同时存在内侧半月板斜行撕裂。胫骨内侧平台或股骨内侧髁骨挫伤的发现可预测斜行撕裂。出现这种骨挫伤模式以及高级别拉赫曼试验和/或轴移试验结果时，应怀疑存在内侧半月板斜行撕裂。
二级，前瞻性队列研究。
