Medial Meniscus Posterior Horn Horizontal Tears are Associated with Knee Posteromedial Impinging Structures Inducing Shearing Forces in Patients with Meniscus Degeneration.

IF 2.7 4区医学 Q1 ORTHOPEDICS

CARTILAGE Pub Date : 2025-07-03 DOI:10.1177/19476035251347728

Sumin Lim, Jun Young Chung, Jae-Young Park, Hee-Woong Yun, Sujin Noh, Do Young Park

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引用次数: 0

Abstract

PurposeThis study aimed to identify potential impinging and shear stress-inducing factors in knees with medial meniscus posterior horn horizontal tears (MMPHHT) using magnetic resonance imaging (MRI) in middle-aged patients with meniscal degeneration.Materials and MethodsWe retrospectively analyzed and compared consecutive patients with MMPH signal changes or MMPHHT on MRI from January 2015 to January 2022. After 1:1 propensity score matching, 80 patients in each group were analyzed. Bony impinging factors, including the femoral condylar offset ratio, the ratio of posterior condylar offset (PCO) to tibial width, posterior medial tibial plateau concavity, and the medial tibial slope, were assessed. Soft tissue impinging factors, such as the MMPH coverage ratio, presence of medial femoral condyle focal cartilage defects or posterior tibial osteophytes, were also analyzed.ResultsDemographic data did not differ between MMPHHT and MMPH signal change groups. MMPHHT group showed increased medial tibial slope (5.33 ± 2.05° vs 4.21 ± 2.58°, P = .003), higher incidence of posterior medial tibial plateau concavity (P = .040), greater MMPH coverage ratio (0.43% ± 0.05% vs 0.41% ± 0.04%, P = .022), and more posterior tibial osteophytes (P = .012). Multivariate logistic regression identified higher medial tibial slope (OR = 1.288, P = .016), MMPH coverage ratio (OR = 1.369 × 10⁴, P = .020), and posterior tibial osteophytes (OR = 4.525, P = .009) as independent factors associated with MMPHHT.ConclusionIn conclusion, we have determined several anatomical contributing factors related to MMPHHT. Such factors may be useful in understanding the progression of meniscus degeneration in early OA knees. Furthermore, addressing correctable factors during surgery such as tibia slope correction or osteophytectomy may improve repair results of MMPHHT in the future.

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内侧半月板后角水平撕裂与半月板退变患者的膝关节后内侧撞击结构诱导剪力有关。

目的利用磁共振成像（MRI）技术，探讨中年半月板退变患者内侧半月板后角水平撕裂（MMPHHT）后膝关节的潜在撞击和剪切应力诱导因素。材料与方法回顾性分析和比较2015年1月至2022年1月MRI上连续出现MMPH信号改变或MMPHHT的患者。经1:1倾向评分匹配，每组80例患者进行分析。评估骨撞击因素，包括股骨髁偏移比、后髁偏移比（PCO）与胫骨宽度的比值、胫骨后内侧平台凹度和胫骨内侧坡度。软组织撞击因素，如MMPH覆盖率，股骨内侧髁局灶性软骨缺损或胫骨后骨赘的存在，也进行了分析。结果MMPHHT组与MMPH信号改变组人口统计学数据无差异。MMPHHT组胫骨内侧斜率增加（5.33±2.05°vs 4.21±2.58°，P = 0.003），胫骨内侧平台后凹发生率增加（P = 0.040）， MMPH覆盖率增加（0.43%±0.05% vs 0.41%±0.04%,P = 0.022），胫骨后骨疣增多（P = 0.012）。多因素logistic回归发现胫骨内侧坡度较高（OR = 1.288, P = 0.016）、MMPH覆盖率（OR = 1.369 × 104, P = 0.020）和胫骨后骨赘（OR = 4.525, P = 0.009）是与MMPHHT相关的独立因素。总之，我们确定了与MMPHHT相关的几个解剖学因素。这些因素可能有助于了解早期OA膝关节半月板变性的进展。此外，在手术中处理可纠正的因素，如胫骨斜面矫正或骨瘤切除术，可能会提高MMPHHT的修复效果。

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来源期刊

CARTILAGE ORTHOPEDICS-

CiteScore

6.90

自引率

7.10%

发文量

期刊介绍： CARTILAGE publishes articles related to the musculoskeletal system with particular attention to cartilage repair, development, function, degeneration, transplantation, and rehabilitation. The journal is a forum for the exchange of ideas for the many types of researchers and clinicians involved in cartilage biology and repair. A primary objective of CARTILAGE is to foster the cross-fertilization of the findings between clinical and basic sciences throughout the various disciplines involved in cartilage repair. The journal publishes full length original manuscripts on all types of cartilage including articular, nasal, auricular, tracheal/bronchial, and intervertebral disc fibrocartilage. Manuscripts on clinical and laboratory research are welcome. Review articles, editorials, and letters are also encouraged. The ICRS envisages CARTILAGE as a forum for the exchange of knowledge among clinicians, scientists, patients, and researchers. The International Cartilage Repair Society (ICRS) is dedicated to promotion, encouragement, and distribution of fundamental and applied research of cartilage in order to permit a better knowledge of function and dysfunction of articular cartilage and its repair.