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内侧半月板撕裂和胫骨高位坡度导致的前交叉韧带断裂:病例报告

ACL rupture from medial meniscus tear and high tibial slope: Case report.

作者信息

Yunqin Xu, Yong Tang, Pan Deng, Yourong Yao, Qiangqiang Wei, Jianmin Wang

机构信息

The Fourth Department of Orthopedics, Center for Orthopedic Trauma of the 72nd Group Army Hospital of the People's Liberation Army, Huzhou City, Zhejiang Province 313000, China.

The Fourth Department of Orthopedics, Center for Orthopedic Trauma of the 72nd Group Army Hospital of the People's Liberation Army, Huzhou City, Zhejiang Province 313000, China.

出版信息

Int J Surg Case Rep. 2025 Jun;131:111352. doi: 10.1016/j.ijscr.2025.111352. Epub 2025 Apr 23.

Abstract

INTRODUCTION AND IMPORTANCE

Tears in the posterior medial meniscus leading to anterior cruciate ligament (ACL) rupture are rare. While the ACL is the primary structure responsible for anterior knee stability, its function can also be influenced by the medial meniscus and the posterior tibial slope.

CASE PRESENTATION

We report a case of a patient with a rupture of the posterior medial meniscus accompanied by a significantly elevated posterior tibial slope. Despite undergoing two arthroscopic meniscectomies, the patient failed to recover. Four years postoperatively, the anterior cruciate ligament degenerated and ruptured.

CLINICAL DISCUSSION

We hypothesize that damage to the posterior medial meniscus may increase stress on the anterior cruciate ligament, particularly in the presence of a high posterior tibial slope.

CONCLUSION

Early surgical repair improved outcomes in medial meniscal posterior horn tears. Tibial slope correction reduced revision rates in patients with >10°tibial slope undergoing ACL reconstruction.

摘要

引言与重要性

内侧半月板后角撕裂导致前交叉韧带(ACL)断裂的情况较为罕见。虽然ACL是维持膝关节前向稳定性的主要结构,但其功能也会受到内侧半月板和胫骨后倾坡度的影响。

病例介绍

我们报告一例内侧半月板后角撕裂伴有显著增大的胫骨后倾坡度的患者。尽管该患者接受了两次关节镜下半月板切除术,但仍未能康复。术后四年,前交叉韧带发生退变并断裂。

临床讨论

我们推测内侧半月板后角损伤可能会增加前交叉韧带上的应力,尤其是在胫骨后倾坡度较大的情况下。

结论

早期手术修复可改善内侧半月板后角撕裂的治疗效果。对于胫骨后倾坡度>10°且接受ACL重建的患者,矫正胫骨坡度可降低翻修率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eda7/12138557/2a2e5c817ea9/gr1.jpg

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