Berlet G C, Fowler P J
Fowler. Kennedy Sport Medicine Clinic, Department of Orthopaedic Surgery, University of Western Ontario, London, Canada.
Am J Sports Med. 1998 Jul-Aug;26(4):540-3. doi: 10.1177/03635465980260041201.
A morphologic study of 48 cadaveric knees was performed to more accurately define the osseous and soft tissue anatomy of the insertion of the anterior horn of the medial meniscus. Soft tissue relationships of the anterior horn of the medial meniscus to the anterior cruciate ligament and the lateral meniscus were examined. Four tibial insertion locations of the medial meniscus were identifiable by bony landmarks. Type I insertions were located in the flat intercondylar region of the tibial plateau; type II occurred on the downward slope from the medial articular plateau to the intercondylar region; type III occurred on the anterior slope of the tibial plateau; there was no firm bony insertion of the anterior horn in type IV. The occurrence for type I was 59% (20 of 34); type II, 24% (8 of 34); type III, 15% (5 of 34); and type IV, 3% (1 of 34). The variance in insertion patterns may have clinical applications for patients with atypical anterior knee pain and for performing meniscal allograft. Type III and type IV insertions may be unable to resist peripheral extrusion of the loaded meniscus, placing it at risk for anterior subluxation and causing anterior knee pain in specific cases. Awareness of these patterns may be valuable in medial meniscus harvest and transplantation.
对48个尸体膝关节进行了形态学研究，以更准确地界定内侧半月板前角附着处的骨性和软组织解剖结构。研究了内侧半月板前角与前交叉韧带和外侧半月板的软组织关系。通过骨性标志可确定内侧半月板的四个胫骨附着位置。I型附着位于胫骨平台的平坦髁间区；II型位于从内侧关节平台到髁间区的下坡处；III型位于胫骨平台的前坡；IV型中内侧半月板前角没有牢固的骨性附着。I型的发生率为59%（34个中有20个）；II型为24%（34个中有8个）；III型为15%（34个中有5个）；IV型为3%（34个中有1个）。附着模式的差异对于非典型前膝痛患者和进行半月板同种异体移植可能具有临床应用价值。III型和IV型附着可能无法抵抗负重半月板的周边挤压，使其有前半脱位的风险，并在特定情况下导致前膝痛。了解这些模式在内侧半月板采集和移植中可能很有价值。
