Simonian P T, Sussmann P S, van Trommel M, Wickiewicz T L, Warren R F
Sports Medicine Service, Hospital for Special Surgery, New York, New York, USA.
Am J Sports Med. 1997 Nov-Dec;25(6):849-53. doi: 10.1177/036354659702500620.
In an attempt to understand better the contribution of the anteroinferior and posterosuperior popliteomeniscal fasciculi to lateral meniscus stability, we objectively evaluated the stability of the lateral meniscus before and after sequentially sectioning these fasciculi. In the biomechanical model, we attempted to account for the inherent limitations of arthroscopic evaluation of lateral meniscal stability. When the fasciculi were intact, the average lateral meniscal motion with a 10-N load was 3.6 mm. When the anteroinferior fascicle was disrupted, the average lateral meniscal motion with a 10-N load was 5.4 mm. The mean increase in motion from the intact state was 1.8 mm or 50%, which was significant. When both fasciculi were disrupted, the average lateral meniscal motion with 10-N load was 6.4 mm. The mean increase in motion from the intact state was 2.8 mm or 78% and from the single fascicle disruption state was 1.0 mm or 18%, both differences were significant. The meniscus did not become locked with any of these loading trials, and it spontaneously reduced to the original position when unloaded. Both fasciculi make significant contributions to meniscal stability. Even though the meniscus never became locked in the joint when loaded during this study, with the variable loads seen with normal activities mechanical symptoms might be expected when meniscal motion is almost double. An increase in lateral meniscal motion at the time of surgery may aid in the diagnosis of fasciculi disruption, despite normal meniscal structure on magnetic resonance images and at arthroscopic visualization.
为了更好地理解腘半月板前下束和后上束对外侧半月板稳定性的作用，我们通过依次切断这些束来客观评估外侧半月板在切断前后的稳定性。在生物力学模型中，我们试图考虑关节镜评估外侧半月板稳定性的固有局限性。当这些束完整时，10牛负荷下外侧半月板的平均移动距离为3.6毫米。当切断前下束时，10牛负荷下外侧半月板的平均移动距离为5.4毫米。与完整状态相比，移动距离平均增加了1.8毫米，即50%，这具有显著性。当两条束都被切断时，10牛负荷下外侧半月板的平均移动距离为6.4毫米。与完整状态相比，移动距离平均增加了2.8毫米，即78%；与单束切断状态相比，增加了1.0毫米，即18%，这两个差异均具有显著性。在任何这些加载试验中，半月板都没有出现交锁，卸载后它会自动恢复到原始位置。两条束对半月板稳定性都有显著贡献。尽管在本研究中加载时半月板在关节内从未出现交锁，但在正常活动中看到的负荷变化情况下，当半月板移动几乎翻倍时，可能会出现机械症状。手术时外侧半月板移动增加可能有助于诊断束的断裂，尽管磁共振成像和关节镜检查时半月板结构正常。
