Lateral meniscus posterior root tear contributes to anterolateral rotational instability and meniscus extrusion in anterior cruciate ligament-injured patients
Lateral meniscus posterior root tear contributes to anterolateral rotational instability and meniscus extrusion in anterior cruciate ligament-injured patients
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DOI：
10.1007/s00167-017-4569-8
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发表时间：
2018-04-01
影响因子：
3.8
通讯作者：
Koga, Hideyuki
中科院分区：
文献类型：
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作者：
Minami, Takao;Muneta, Takeshi;Koga, Hideyuki
本研究的目的是调查（1）前交叉韧带（ACL）损伤患者的半月板状态和临床表现，以阐明半月板后根撕裂（PRT）与膝关节不稳定之间的关系，（2）磁共振成像（MRI）PRT的结果，以阐明MRI的敏感性和特异性以及半月板挤出的患病率。包括重建。通过审查手术记录确认了内侧和外侧的PRT。回顾术前MRI以评价PRT和半月板挤出宽度（MEW）的敏感性和特异性。临床信息的数量给的方式发作，术前KT-1000测量和术前枢轴shift.39例患者有外侧半月板（LM）PRT，而只有4例患者有内侧半月板PRT。117例患者无半月板撕裂（对照组）。28例患者（71.8%）显示出基于至少一个MR图像视图的LMPRT阳性体征，冠状位视图显示出最高的灵敏度。LMPRT组MEW明显大于对照组。LMPRT组术前轴移试验评分明显高于对照组。在ACL损伤的患者中，LMPRT与ALRI以及半月板挤压相关。MRI冠状位对LMPRT的诊断有一定价值，但敏感性不高。因此，无论MRI结果如何，外科医生都应在ACL重建时准备修复PRT，并应尽一切努力修复LMPRT。III.
The purposes of this study were to investigate (1) meniscus status and clinical findings in anterior cruciate ligament (ACL)-injured patients to clarify associations between the meniscus posterior root tear (PRT) and knee instability, and (2) magnetic resonance imaging (MRI) findings of the PRT to clarify sensitivity and specificity of MRI and prevalence of meniscus extrusion.Three hundred and seventeen patients with primary ACL reconstruction were included. PRTs for both medial and lateral sides were confirmed by reviewing surgical records. Preoperative MRI was reviewed to evaluate sensitivity and specificity of the PRT and meniscus extrusion width (MEW). Clinical information regarding the number of giving-way episodes, preoperative KT-1000 measurements and preoperative pivot shift was also assessed.Thirty-nine patients had a lateral meniscus (LM) PRT, whereas only four patients had a medial meniscus PRT. One hundred and seventeen patients had no meniscus tear (control). Twenty-eight patients (71.8%) showed positive signs of the LMPRT based on at least one view of MR images, with the coronal view showing the highest sensitivity. MEW in the LMPRT group was significantly larger than that in the control group. The preoperative pivot shift test grade in the LMPRT group was significantly greater than that in the control group. There were no significant differences in other parameters.In ACL-injured patients, the LMPRT was associated with ALRI as well as with meniscus extrusion. The coronal view of MRI was useful in identifying the LMPRT, although its sensitivity was not high. Therefore, surgeons should prepare to repair PRTs at the time of ACL reconstruction regardless of MRI findings, and they should make every effort to repair the LMPRT.III.