[1]李精敏,宁思敏,姜劲松△.膝关节内侧半月板后角根部撕裂伴移位的相关危险因素分析[J].中国中医骨伤科杂志,2024,32(07):46-51+56.[doi:10.20085/j.cnki.issn1005-0205.240708 ]
　LI Jingmin,NING Simin,JIANG Jinsong.Risk Factors Analysis of Tear and Displacement of the Posterior Horn Root of the Medial Meniscus of the Knee Joint[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(07):46-51+56.[doi:10.20085/j.cnki.issn1005-0205.240708 ]
点击复制

膝关节内侧半月板后角根部撕裂伴移位的相关危险因素分析()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年07期
页码:
46-51+56
栏目:
临床研究
出版日期:
2024-07-15

文章信息/Info

Title:
Risk Factors Analysis of Tear and Displacement of the Posterior Horn Root of the Medial Meniscus of the Knee Joint
文章编号:
1005-0205(2024)07-0046-06
作者:
李精敏1; 宁思敏1; 姜劲松1△
1运城市中心医院(山西 运城,044000)
Author(s):
LI Jingmin1; NING Simin1; JIANG Jinsong1△
1Yuncheng Central Hospital,Yuncheng 044000,Shanxi China.
关键词:
膝关节;  半月板撕裂;  移位;  磁共振成像;  危险因素
Keywords:
knee joint;  meniscal tear;  displacement;  magnetic resonance imaging;  risk factors
分类号:
R684
DOI:
10.20085/j.cnki.issn1005-0205.240708
文献标志码:
A
摘要:
目的:探讨膝关节内侧半月板后角根部撕裂伴移位的危险因素。方法:收集2021年7月至2023年7月就诊的300例膝关节内侧半月板后角根部撕裂患者临床资料,根据移位程度分成观察组和对照组,对比分析两组患者的性别、年龄、体重指数、病程、损伤部位、内侧胫骨平台后倾角、半月板绝对脱出值和相对脱出率、关节软骨损伤程度、关节积液及骨髓水肿等因素,然后进行多因素Logistic回归分析后角根部撕裂伴移位的相关危险因素。结果:单因素分析发现观察组绝对脱出值((4.37±0.87)mm)高于对照组((3.69±0.77)mn),差异有统计学意义(P<0.05); 观察组相对脱出率(31.45%±8.46%)高于对照组(22.81%±9.53%),差异有统计学意义(P<0.05); 观察组内侧胫骨平台后倾角(5.43°±1.82°)大于对照组(4.86°±1.91°),差异有统计学意义(P<0.05); 两组比较分析发现年龄、体重指数、内侧胫骨平台软骨损伤程度,差异有统计学意义(P<0.05); 两组在性别、病程、损伤部位、关节积液、股骨内侧髁软骨损伤程度、股骨内侧髁骨髓水肿、内侧胫骨平台骨髓水肿等方面比较差异无统计学意义(P>0.05); 多因素logistic回归分析发现绝对脱出值(OR=2.205,P=0.019)、相对脱出率(OR=0.914,P=0.024)、内侧胫骨平台后倾角(OR=1.911,P=0.019)是内侧半月板后角根部撕裂伴移位的危险因素,而年龄、体重指数、内侧胫骨平台软骨损伤等不是影响因素。结论:半月板绝对脱出值和相对脱出率与胫骨平台后倾角增大是膝关节内侧半月板后角根部撕裂伴移位的危险因素,胫骨平台后倾角测量在诊断中具有较高的检出率和敏感性,伴移位患者半月板脱出和关节软骨损伤程度更严重。
Abstract:
Objective:To explore the risk factors of tear and displacement of the posterior horn root of the medial meniscus of the knee joint.Methods:Clinical data of 300 patients with posterior heel tear of the medial meniscus of the knee joint who were treated from July 2021 to July 2023 were collected.They were divided into observation group and control group based on the degree of displacement.The gender,age,body mass index,course of disease,injury site,posterior inclination angle of the medial tibial plateau,absolute and relative prolapse rate of the meniscus,degree of joint cartilage injury single factor comparative analysis was conducted on joint effusion and bone marrow edema,and statistically significant indicators were included in the multivariate logistic regression equation to analyze the risk factors for their occurrence.Results:Univariate analysis found that the absolute protrusion value((4.37±0.87)mm)in the observation group was higher than that in the control group((3.69±0.77)mm)(P<0.05),the relative protrusion rate(31.45%±8.46%)in the observation group was higher than that in the control group(22.81%±9.53%)(P<0.05),and the posterior inclination angle of the medial tibial plateau(5.43°±1.82°)in the observation group was higher than that in the control group(4.86°±1.91°)(P<0.05).Comparative analysis between the two groups found that age,body mass index,there was a significant statistical difference(P<0.05)in the degree of damage to the medial tibial plateau cartilage between the two groups,but there was no statistically significant difference(P>0.05)in terms of gender,disease course,injury site,joint effusion,degree of damage to the medial femoral condyle cartilage,bone marrow edema of the medial femoral condyle,and bone marrow edema of the medial tibial plateau.Multivariate logistic regression analysis found that absolute prolapse value(OR=2.205,P=0.019),relative prolapse rate(OR=0.914,P=0.024),and medial tibial plateau posterior inclination angle(OR=1.911,P=0.019)were risk factors for medial meniscus posterior angle root tear,while age,body mass index,medial tibial plateau cartilage injury,and other factors were not influencing factors.Conclusion:The absolute and relative prolapse values of the meniscus,as well as the increase in the posterior inclination angle of the tibial plateau,are risk factors for the root tear displacement of the posterior horn of the medial meniscus.The measurement of tibial plateau tilt angle has a high detection rate and sensitivity in diagnosis,and patients with displacement have more severe meniscus prolapse and joint cartilage damage.

参考文献/References:

[1] CALANNA F,DUTHON V,TSCHOLL P M,et al.Classification and treatment of modern traumatic meniscal tears[J].Rev Med Suisse,2021,17(745):1301-1309.
[2] RODEO S A,MONIBI F,DEHGHANI B,et al.Biological and mechanical predictors of meniscus function:basic science to clinical translation[J].J Orthop Res,2020,38(5):937-945.
[3] 刘兆亮,孙雪冬,王军,等.膝内侧半月板与软骨退变损伤的相关性研究[J].精准医学杂志,2019,34(2):179-182.
[4] 苏家荣,孙铁铮.内侧半月板后根撕裂研究进展[J].中国运动医学杂志,2021,40(9):721-728.
[5] 王军凯,王亚魁,赵红亮,等.膝内侧半月板后角根部撕裂伴移位的临床及影像分析[J].放射学实践,2022,37(8):1014-1017.
[6] KORNAAT P R,CEULEMANS R Y,KROON H M,et al.MRI assessment of knee osteoarthritis:knee osteoarthritis scoring system(KOSS)inter-observer and intra-observer reproducibility of a compartment-based scoring system[J].Skeletal Radiol,2004,34(2):95-102.
[7] 周航,冯硕,张金成,等.胫骨平台解剖形态与半月板撕裂的相关性[J].中国组织工程研究,2023,27(31):4977-4983.
[8] ZHAO X,KUANG S D,SU C,et al.Arthroscopic treatment of femoral avulsion fracture of the posterior cruciate ligament in association with meniscus tear[J].Orthop Surg,2020,12(2):692-697.
[9] BERNHOLT D L,DEPHILLIPO N N,CRAWFORD M D,et al.Incidence of displaced posterolateral tibial plateau and lateral femoral condyle impaction fractures in the setting of primary anterior cruciate ligament tear[J].Am J Sports Med,2020,48(3):545-553.
[10] SUNDARARAJAN S R,RAMAKANTH R,SETHU- RAMAN A S,et al.Correlation of factors affecting correction of meniscal extrusion and outcome after medial meniscus root repair[J].Arch Orthop Trauma Surg,2021,142(5):823-834.
[11] 彭超,刘云鹏,华国军,等.退行性内侧半月板后根撕裂半月板部分切除前后髋膝踝角与骨性关节炎进展的影像学评估[J].中国组织工程研究,2021,25(21):3368-3373.
[12] OKAZAKI Y,FURUMATSU T,SHIMAMURA Y,et al.Time-dependent increase in medial meniscus extrusion after medial meniscus posterior root tear analyzed by using magnetic resonance imaging[J].Knee Surg Relat Res,2019,31(2):120-125.
[13] WOLF B R,GULBRANDSEN T R.Degenerative meniscus tear in older athletes[J].Clin Sports Med,2020,39(1):197-209.
[14] KENNEDY M L,STRAUSS M,LAPRADE R F.Injury of the meniscus root[J].Clin Sports Med,2020,39(1):57-68.
[15] DEBIEUX P,JIMENEZ A E,NOVARETTI J V,et al.Medial meniscal extrusion greater than 4 mm reduces medial tibiofemoral compartment contact area:a biomechanical analysis of tibiofemoral contact area and pressures with varying amounts of meniscal extrusion[J].Knee Surg Sports Traumatol Arthrosc,2021,29(9):3124-3132.
[16] 汪睿,钱银锋,王紫明,等.半月板根部撕裂与膝骨性关节炎严重度的关系[J].放射学实践,2019,34(6):664-667.
[17] AKHAVAN S,MARTINKOVICH S C,KASIK C,et al.Bone marrow edema,clinical significance,and treatment options:a review[J].J Am Acad Orthop Surg,2020,28(20):e888-e899.

备注/Memo

备注/Memo:
基金项目:运城市2021年科技计划项目(基础研究计划项目)(YCKJ-2021056-12)
△通信作者 E-mail:hyp0790@126.com
更新日期/Last Update: 2024-07-05